RHODE ISLAND FIDUCIARY INCOME TAX RETURN PAYMENT 
                 RI DIVISION OF TAXATION - ONE CAPITOL HILL 
                        PROVIDENCE, RI 02908-5807
                                                                                          17105899990101

 Fiscal year filers, enter fiscal year dates 
 MM/DD/2023  through  MM/DD/2024                                              2023 RI-1041V
 Name of estate or trust

 Address

 City                   State                           ZIP Code

        Federal employer identification number                     ENTER AMOUNT ENCLOSED

                        DETACH VOUCHER AT PERFORATION TO MAIL IN WITH YOUR PAYMENT

        State of Rhode Island Division of Taxation 
        2023 Form RI-1041V 
        Fiduciary Income Tax Return Payment

What Is Form RI-1041V and Do You Need To Use It?                          How To Prepare  Your Payment
 
It is a statement you send with your payment of any                       Make your check or money order payable to the "R.I. Division  
balance due on line 16c of your Form RI-1041.  Using Form RI-             of Taxation."  Do not send cash.  Make sure the entity’s name and 
1041V allows us to process your payment more accurately and               address appear on the check or money order.  Write "Form RI-
efficiently.  We strongly encourage you to use Form RI-1041V, but         1041V," your daytime phone number and the federal employer 
there is no penalty if you do not do so.                                  identification number on your check or money order.   
 
How To Fill In Form RI-1041V                                               
 
                                                                          How To Send In Your Return, Payment, and RI-1041V
                                                                                                                                 
                                                                          Detach and return the top portion with your payment.   DO NOT 
                                             2023                         staple or otherwise attach your payment of Form RI-1041V to your 
 1                                                                        return or to each other.  Instead, just put them loose in an enve-
                                                                          lope.  Mail your tax return, payment and Form RI-1041V to the 
                                                                        3 Rhode Island Division of Taxation, One Capitol Hill, Providence, 
 2                                                                        RI  02908-5807. 
 
Box 1.   Enter the name and address as shown on your return. 
                                                                           
             If the return is for a fiscal year, enter the fiscal years   FREE INTERNET FILING/PAYMENT AVAILABLE 
        date in the space provided. 
                                                                           
Box 2.   Enter the Federal employer identification number in the          You may pay your balance due electronically 
        box provided.                                                     using the RI Division of Taxation’s Portal. 
 
Box 3.   Enter the amount of the payment you are making.                   
             Also,  enter  the  payment  information  below  for  your    FOR MORE INFORMATION VISIT: 
        records.                                                          https://taxportal.ri.gov 
 
                 Date Paid        Check Number              Amount