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34567890123456789012345678901234567890123456789012345678901234567890123456789012RHODE ISLAND FIDUCIARY INCOME TAX RETURN PAYMENT
4 RI DIVISION OF TAXATION - ONE CAPITOL HILL 4
5 PROVIDENCE, RI 02908-5807 5
6 17105899990101 6
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8 Fiscal year filers, enter fiscal year dates 8
9 09/01/2023MM/DD/2023 through MM/DD/202408/31/2024 2023 RI-1041V 9
10 Name of estate or trust 10
11 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 11
12 Address 12
13 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 13
14 City State ZIP Code 14
15 XXXXXXXXXXXXXX XX 99999 15
16 Federal employer identification number ENTER AMOUNT ENCLOSED 9999999999999 99 16
17 999999999 17
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23 DETACH VOUCHER AT PERFORATION TO MAIL IN WITH YOUR PAYMENT 23
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25 State of Rhode Island Division of Taxation 25
26 2023 Form RI-1041V 26
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28 Fiduciary Income Tax Return Payment 28
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31 What Is Form RI-1041V and Do You Need To Use It? How To Prepare Your Payment 31
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33 It is a statement you send with your payment of any Make your check or money order payable to the "R.I. Division 33
34 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 34
35 1041V allows us to process your payment more accurately and address appear on the check or money order. Write "Form RI- 35
36 efficiently. We strongly encourage you to use Form RI-1041V, but 1041V," your daytime phone number and the federal employer 36
there is no penalty if you do not do so. identification number on your check or money order.
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38 How To Fill In Form RI-1041V 38
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How To Send In Your Return, Payment, and RI-1041V
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42 DRAFT Detach and return the top portion with your payment. DO NOT 42
43 2023 staple or otherwise attach your payment of Form RI-1041V to your 43
1 return or to each other. Instead, just put them loose in an enve-
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lope. Mail your tax return, payment and Form RI-1041V to the
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46 3 Rhode Island Division of Taxation, One Capitol Hill, Providence, 46
2 RI 02908-5807.
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49 Box 1. Enter the name and address as shown on your return. 49
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If the return is for a fiscal year, enter the fiscal years FREE INTERNET FILING/PAYMENT AVAILABLE
51 date in the space provided. 51
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Box 2. Enter the Federal employer identification number in the 09/12/2023You may pay your balance due electronically
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54 box provided. using the RI Division of Taxation’s Portal. 54
55 Box 3. Enter the amount of the payment you are making. 55
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Also, enter the payment information below for your FOR MORE INFORMATION VISIT:
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58 records. https://taxportal.ri.gov 58
59 Date Paid Check Number Amount 59
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