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2007 PFC Letter for Electronic Filers

02/17/2008
Dear Taxpayer:

349-82-2391

Your electronically filed 2007 Indiana Individual Income Tax Return indicates a balance owed to the Indiana Department of Revenue in the amount of $ 99.00 . If you have any questions regarding this amount owed, you should consult the tax preparer who prepared your income tax return electronically. Avoid penalty and interest charges by making your payment before the April 15,2008, tax due date. You may pay by mail, by telephone, or via the Internet. To pay by paper check or money order, mail your payment and the tear-off coupon at the bottom of this letter to: Indiana Department of Revenue, PO Box 1674, Indianapolis, IN 46206-1674. Make your check or money order payable to “Indiana Department of Revenue”. PLEASE DO NOT SEND CASH. You may also pay by using the Indiana IN-ePay System. You may pay by electronic Check (eCheck) over the Internet by accessing our webpage at www.in.gov/dor/epay and follow the instructions. The fee for paying by eCheck is $1.00. Finally, you may also use the Indiana IN-ePay System to pay by a major credit card You can access this payment method at the webpage indicated above or by touch tone telephone at 1-800-2PAYTAX (1-800-272-9829) toll free. You will then be prompted for the information necessary to make your payment. A convenience fee will be charged by the credit card processor based on the amount of tax you are paying. You will be told what the fee is and you will have the option to cancel or continue the credit card transaction. Sincerely, INDIANA DEPARTMENT OF REVENUE

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PFC

Mail and make check payable to:

Indiana Department of Revenue P.O. Box 1674 Indianapolis IN 46206-1674

Danielle E Knoblett 356 Mill Springs fillmore, IN 46128
Amount Due:

DCN 0 0 Form

8

IT-8453OL
State Form 46201 (R6 / 8-07)

Do Not Mail This Form

Indiana Individual Income Tax

DECLARATION OF ELECTRONIC FILING
For the tax year January 1 - December 31, 2007
Last Name Your Social Security Number

First Name(s) and Middle Initial(s)

Danielle E
Spouse's First Name(s) and Middle Initial(s) Street Address

Knoblett
Last Name

349-82-2391
Spouse's Social Security Number Apartment Number

356 Mill Springs
City State Zip Code Daytime Telephone Number

fillmore

IN

46128

(765)246-6050
1. 2. 3. 4. 5. 6. 7. 8.

Part I Tax Return Information (Whole Dollar Amounts Only)
1. Federal Adjusted Gross Income (Form IT-40, Line 1 or IT-40EZ, Line 1) . . . . . 2. Indiana taxable income (Form IT-40, Line 15 or IT-40EZ, Line 5) . . . . . . . . 3. Total Indiana tax (Form IT-40, Line 22 or IT-40EZ, Line 9) . . . . . . . . . . . . 4. Total state tax withheld (Form IT-40, Line 23 or IT-40EZ, Box 10) . . . . . . . . 5. Total county tax withheld (Form IT-40, Line 24 or IT-40EZ, Box 11) . . . . . . . 6. Total Indiana tax credits (Form IT-40, Line 31 or IT-40EZ, Line 13) . . . . . . . 7. Refund (Form IT-40, Line 39 or IT-40EZ, Line 16) . . . . . . . . . . . . . . . . . 8. Amount you owe (Form IT-40, Line 44 or IT-40EZ, Line 21) . . . . . . . . . . .

9,854.00 8,854.00 434.00 335.00

DO NOT MAIL
Part II
Direct Deposit

335.00

99.00

A T T A C H W 2 F O R M S H E R E

9. Routing number 10. Account number 11. Type of account: Checking Savings

Note: The first two digits of the routing number must be 01 - 12 or 21 - 32.

Do Not Mail Hoosier Works MC This Form

My request for direct deposit of my refund includes my authorization for the Indiana Department of Revenue to furnish my financial institution with my routing number, account number, account type, and social security number to insure my refund is properly deposited.

I N D I A N A

Part III

Declaration of Taxpayer

If I have filed a balance due return, I understand that if the IDOR does not receive full and timely payment of my tax liability, I will remain liable for the tax liability and all applicable interest and penalties. Under penalties of perjury, I declare that the amounts in Part I above agree with the amounts on the corresponding lines of the electronic portion of my 2007 income tax return. To the best of my knowledge and belief, my return is true correct and complete. I consent to allow my transmitter to send my return, this declaration, and accompanying schedules and statements to the IDOR. I also consent to the IDOR sending an acknowledgement of receipt of transmission and an indication of whether or not my return is accepted, and, if rejected, the reason(s) for the rejection.

Please Sign Here Taxpayer's Signature
1064

Date

Spouse's Signature

Date