Massachusetts                                                                                             Voucher 1
1-ESDepartment of RevenueEstimated Tax Payment — 2010
Social Security number   Spouse’s Social Security no.          Due date        Voucher Estimated tax for the year ending

                                                                               1       MONTH //DAY                      YEAR
Last name (print)        First name and initial (and spouse’s, if joint return)       1. Amount of this installment (from line 12 of esti-
                                                                                       mated tax worksheet):
                                                                                      $
Street address                                                                        Check which form you plan to file:
                                                                                       Form 1 Full-Year Resident
                                                                                       Form 1-NR/PY Nonresident/Part-Year Resident
                                                                                       Nonresident Composite Return
City/Town                                                 StateZip
                                                                                      Important Information
                                                                                      File your Form 1-ES online at
Return this voucher with check or money order payable to:                             no cost! It’s fast, easy and se-
Commonwealth of Massachusetts.
                                                                                      cure. Go to www.mass.gov/dor
Mail to:                                                                              and click on WebServices for
Massachusetts Department of Revenue, PO Box 7007, Boston, MA 02204.                   Income for more information.
For Privacy Act Notice, see instructions for the form you file.

              Massachusetts                                                                                             Voucher 2
1-ESDepartment of RevenueEstimated Tax Payment — 2010
Social Security number   Spouse’s Social Security no.          Due date        Voucher Estimated tax for the year ending

                                                                               2       MONTH //DAY                      YEAR
Last name (print)        First name and initial (and spouse’s, if joint return)       1. Amount of this installment (from line 12 of esti-
                                                                                       mated tax worksheet):
                                                                                      $
Street address                                                                        Check which form you plan to file:
                                                                                       Form 1 Full-Year Resident
                                                                                       Form 1-NR/PY Nonresident/Part-Year Resident
                                                                                       Nonresident Composite Return
City/Town                                                 StateZip
                                                                                      Important Information
                                                                                      File your Form 1-ES online at
Return this voucher with check or money order payable to:                             no cost! It’s fast, easy and se-
Commonwealth of Massachusetts.
                                                                                      cure. Go to www.mass.gov/dor
Mail to:                                                                              and click on WebServices for
Massachusetts Department of Revenue, PO Box 7007, Boston, MA 02204.                   Income for more information.
For Privacy Act Notice, see instructions for the form you file.

              Massachusetts                                                                                             Voucher 3
1-ESDepartment of RevenueEstimated Tax Payment — 2010
Social Security number   Spouse’s Social Security no.          Due date        Voucher Estimated tax for the year ending

                                                                               3       MONTH //DAY                      YEAR
Last name (print)        First name and initial (and spouse’s, if joint return)       1. Amount of this installment (from line 12 of esti-
                                                                                       mated tax worksheet):
                                                                                      $
Street address                                                                        Check which form you plan to file:
                                                                                       Form 1 Full-Year Resident
                                                                                       Form 1-NR/PY Nonresident/Part-Year Resident
                                                                                       Nonresident Composite Return
City/Town                                                 StateZip
                                                                                      Important Information
                                                                                      File your Form 1-ES online at
Return this voucher with check or money order payable to:                             no cost! It’s fast, easy and se-
Commonwealth of Massachusetts.
                                                                                      cure. Go to www.mass.gov/dor
Mail to:                                                                              and click on WebServices for
Massachusetts Department of Revenue, PO Box 7007, Boston, MA 02204.                   Income for more information.
For Privacy Act Notice, see instructions for the form you file.

              Massachusetts                                                                                             Voucher 4
1-ESDepartment of RevenueEstimated Tax Payment — 2010
Social Security number   Spouse’s Social Security no.          Due date        Voucher Estimated tax for the year ending

                                                                               4       MONTH //DAY                      YEAR
Last name (print)        First name and initial (and spouse’s, if joint return)       1. Amount of this installment (from line 12 of esti-
                                                                                       mated tax worksheet):
                                                                                      $
Street address                                                                        Check which form you plan to file:
                                                                                       Form 1 Full-Year Resident
                                                                                       Form 1-NR/PY Nonresident/Part-Year Resident
                                                                                       Nonresident Composite Return
City/Town                                                 StateZip
                                                                                      Important Information
                                                                                      File your Form 1-ES online at
Return this voucher with check or money order payable to:                             no cost! It’s fast, easy and se-
Commonwealth of Massachusetts.
                                                                                      cure. Go to www.mass.gov/dor
Mail to:                                                                              and click on WebServices for
Massachusetts Department of Revenue, PO Box 7007, Boston, MA 02204.                   Income for more information.
For Privacy Act Notice, see instructions for the form you file.