Get Form 13973

Form 13973 is a health coverage tax credit (HCTC) blank payment coupon used for making payments to the HCTC Program. This guide provides step-by-step instructions on how to complete the form online for a seamless payment experience.

Follow the steps to effectively complete and submit the Form 13973 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor. This will allow you to fill out the form electronically.
2. Complete the required information in the designated fields. Input your HCTC account number, participant name, street address, city, state, and zip code accurately.
3. For credit card payments, make sure to enter your card number, expiration date, billing zip code, and CVV number in the appropriate spaces on the form.
4. Review the entered information carefully to ensure accuracy to avoid any delays in processing your payment.
5. Once all fields are completed, save your changes and prepare to print the document. This step is crucial before sending it in.
6. Print the filled-out coupon. Make sure the printout is clear and legible.
7. Cut along the indicated line of the payment coupon to separate it from the remainder of the form.
8. Send the completed payment coupon along with your payment to the provided address: US Treasury – HCTC, P.O. Box 970023, St. Louis, MO 63197-0023.

Complete the Form 13973 online and ensure timely processing of your payment.