Form R-540v-Sd06 - Individual Income Tax Electronic Filing Payment Voucher
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1In order as listed on tax return
.
.
R-540V-SD06 WEB
Individual Income Tax Electronic
Filing Payment Voucher
IMPORTANT NOTICE
Louisiana Department of Revenue
P.O. Box 3550
Baton Rouge, LA 70821-3550
Tax preparers should provide this form to clients who file electronically if a payment is due with the return. Taxpayer
clients who owe additional Louisiana individual income tax for 2006 must complete the payment voucher at the bottom
of this page, detach and mail by May 15, 2007, in order to avoid the assessment of penalties and interest. The top
portion of this form should also be completed and retained by the taxpayer as a record of payment.
DO NOT SEND CASH.
Complete and retain this portion as a record of payment.
Direct debit is available via the internet.
Go to
In order as listed on tax return
Your Name
Your Social Security Number (1)
Spuse’S Name
Your spouse's Social Security Number (2)
Address
City
State
ZIP
Amount of payment
Check Number
Date Sent
Detach and submit the voucher below with your payment by May 15, 2007.
Individual Income Tax Electronic Filing Payment Voucher
R-540V-SD06 WEB
E
Name
Spouse’s Name
Print in order as listed above.
Your Social Security Number (1)
Address
Your spouse's Social Security Number (2)
City, State, ZIP
Make payment to:
Amount Enclosed
Louisiana Department of Revenue
P. O. Box 3550
Baton Rouge, LA 70821-3550
Please include your Social Security
Number on your payment.
DO NOT SEND CASH.
Mail Date
1903
For office use only.
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