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CENTER SIDES. PRINTS: HEAD TO HEAD PAPER: WHITE WRITING, SUB. 20. INK: BLACK FLAT SIZE: 203 mm (8") x 279 mm (11") PERFORATE: (NONE) DO NOT PRINT DO NOT PRINT DO NOT PRINT DO NOT PRINT Date Separation 1 of 2: Black Action Date Signature O.K. to print Revised proofs requested Separation 2 of 2: PMS 185 (RED) Write the words Stimulus Payment across the top of the form you file. Form Department of the Treasury Internal Revenue Service 1040A U.S. Individual Income Tax.

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