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Formulario 481 Rev. 29 oct 12 FORMA CORTA Revisor Liquidador N mero de Serie PLANILLA CON CHEQUE FAVOR DE FIJAR CHEQUE EN ESTE LUGAR ESTADO LIBRE ASOCIADO DE PUERTO RICO DEPARTAMENTO DE HACIENDA PLANILLA DE CONTRIBUCION SOBRE INGRESOS DE INDIVIDUOS PLANILLA ENMENDADA A O CONTRIBUTIVO 2012 O A O COMENZADO EL R G RO V1 V2 P1 P2 N D1 D2 E A M FALLECIDO DURANTE EL A O // D a Mes A o de de Y TERMINADO EL de de Nombre del Contribuyente Inicial Apellido Paterno CONTRIBUYENTE N mero de Seguro Social...
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