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Form 760-PFF 2013 Payment Coupon for Farmers, Fishermen and Merchant Seamen

(DOC ID 764) Please do not staple

To Be Used For Payments On Previously 

Filed 2013 Individual Income Tax Returns Only

Your Social Security NumberSpouse’s Social Security Number

Mail Payment To: 

VA Department of Taxation 

P.O. Box 1478 

Richmond, VA 23218-1478

 

 

 

 

 

 

 

 

 

Name(s)

Address

CityStateZIP

Daytime Phone NumberAmount of Payment

Make your check payable to the 

Virginia Department of Taxation

.0 0

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