“Treasurer, State of Maine.”

1 Form 1040 EXT-ME Extension Payment Voucherfor Individual Income Tax maine EZ PayPay your income tax electronically at and eliminate the necessity of fi ling Form 1040 EXT-ME (individual income tax extension payment voucher). maine EZ Pay is an online application that allows maine taxpayers to make payments online, quickly and easily. To avoid having to make payments earlier than necessary, payments may be scheduled in advance and will automatically be withdrawn on the payment date the taxpayer must pre-register online with personal and bank account information, and payments will be withdrawn from the checking or savings account that is set up in the registration. For more information, see (click on Electronic Services).To mail your payment, follow the instructions your name(s), social security number(s), telephone number and address in the spaces provided.

2 If you are fi ling a joint return, enter your names and social security numbers in the same order as they appear on your the amount of your check or money order in the space checks payable to treasurer , State of maine . Mail your completed Form 1040 EXT-ME and payment to maine Revenue Services, PO Box 9101, Augusta, ME NOT STAPLE OR TAPE CHECK TO YOUR FORM. DO NOT CUT OR DETACH THIS FORM. Your First Name Initial Your Social Security NumberYour Last Name Spouse s Social Security NumberSpouse s First Name Initial Area Code Home Phone NumberSpouse s Last Name Area Code Work Phone NumberAddress (number, street and apt. no.)City/Town State ZIP CodeAmount Paid with this voucher.

3 00201699*1201600*