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1040 V Irs Form

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1040 V Irs Form Powered By Docstoc
					    ACCEPTED FOR VALUE – RETURNED FOR VALUE
   EXEMPT FROM LEVY – PREPAID COMMON STOCK
 DISCHARGE ALL PRESENTMENTS AND RELATED FEES
          ADJUST THE BALANCE TO ZERO
 PRIVATE PREPAID TREASURY EXEMPTION # 123456789
    CHARGE THE SAME TO: JOHN H DOE 123-45-6789
____________________________________ _____________
             SIGNATURE                   DATE

				
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posted:11/19/2010
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Description: 1040 V Irs Form document sample