te bill for $50 for each return or other tax document associated with the returned payment Privacy notification See our website or Publication 54, Privacy Notification. Specific Instructions Filling in your form - Please use black ink (and never use red ink) when making entries on this form. Name and address box

bill for $50 for each return or other tax document associated with the returned payment. Privacy notification See our Web site or Publication 54, Privacy Notification. Specific instructions Name and address box' Enter your name (both names if filing a joint application). address and social security number(s). F