Utah State Tax Commission
                                                                                                                           TC-547
Individual Income Tax Return Coupon                                                                                        Rev. 12/11

Use of Payment Coupon                                                      Print your name and address, daytime telephone number and the year 
                                                                           the payment is for on your check or money order.
If you have a tax due balance on your Utah individual income tax 
return and you have previously filed your return (either electronically or 
by paper) without a payment, include the payment coupon below with         Sending Payment Coupon
your check or money order to insure proper credit to your account. Do      If sending this payment coupon separate from your individual income 
not mail another copy of your income tax return with this payment.         tax return, do NOT mail another copy of your return with this payment.
Sending a duplicate of your return may delay posting of the payment.
                                                                           Complete and detach the payment coupon below.
If you are sending a payment with your paper Utah individual income 
tax return, include the payment coupon below with your check or            Do not attach (staple, paper clip, etc.) the check or money order to the 
money order, to insure proper credit to your account.                      payment coupon. 
Do not use this return payment coupon to prepay future individual          Send the payment coupon and payment to:
income taxes. Use form TC-546.                                              Utah State Tax Commission
                                                                            210 N 1950 W
Electronic Payment                                                          Salt Lake City, UT 84134-0266
You may pay your tax online at tap.utah.gov.

How to Prepare the Payment
Make your check or money order payable to the Utah State Tax 
Commission. Do not send cash. The Tax Commission does not 
assume liability for loss of cash placed in the mail. 

                                                                                                     Clear form

SEPARATE AND RETURN ONLY THE BOTTOM COUPON WITH PAYMENT. KEEP TOP PORTION FOR YOUR RECORDS.

                                                                                                                           TC-547
Individual Income Tax                       Mail to: Utah State Tax Commission, 210 N 1950 W, SLC UT 84134-0266            Rev. 12/11
Return Payment Coupon Primary taxpayer name                                                      Social Security no.
                                                                                                                                      I
Tax year ending                                                                                                                       I
                                            Secondary taxpayer name                              Social Security no.                  T

USTC Use Only                                                                                                                         0
                                            Address                                                                                   0

                                            City                                                 State            ZIP code            4

                                                                            Payment amount enclosed $                      00
                                                                           Make check or money order payable to the Utah State Tax Commission.
                                                                           Do not send cash. Do not staple check to coupon. Detach check stub.