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Get Form R 54ov Sd

State of Louisiana Department of Revenue P. O. Box 201 Baton Rouge LA 70821-0201 R-540V 03 Individual Income Tax Electronic Filing Payment Voucher Important notice 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 2003 must complete the payment voucher at the bottom of this page detach and mail by May 17 2004 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. You can also make payments via the internet. Go to www. revenue. louisiana*gov* Name In order as listed on tax return Address Your Social Security Number 1 City State ZIP Your spouse s Social Security Number 2 Amount of payment Check number Date sent Detach and submit the voucher below with your payment by May 17 2004. Name Address For office use only. 62222 Make payment to Louisiana Department of Revenue Do not send cash. 12312003 AMOUNT ENCLOSED Mail date E Print in order as listed above. Please include your Social Security Number on your payment. 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. You can also make payments via the internet. DO NOT SEND CASH. Complete and retain this portion as a record of payment. You can also make payments via the internet. Go to www. revenue. louisiana*gov* Name In order as listed on tax return Address Your Social Security Number 1 City State ZIP Your spouse s Social Security Number 2 Amount of payment Check number Date sent Detach and submit the voucher below with your payment by May 17 2004. Go to www. revenue. louisiana*gov* Name In order as listed on tax return Address Your Social Security Number 1 City State ZIP Your spouse s Social Security Number 2 Amount of payment Check number Date sent Detach and submit the voucher below with your payment by May 17 2004. Name Address For office use only. 62222 Make payment to Louisiana Department of Revenue Do not send cash. Name Address For office use only. 62222 Make payment to Louisiana Department of Revenue Do not send cash. 12312003 AMOUNT ENCLOSED Mail date E Print in order as listed above. Please include your Social Security Number on your payment. 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. You can also make payments via the internet. Go to www. revenue. louisiana*gov* Name In order as listed on tax return Address Your Social Security Number 1 City State ZIP Your spouse s Social Security Number 2 Amount of payment Check number Date sent Detach and submit the voucher below with your payment by May 17 2004. DO NOT SEND CASH. Complete and retain this portion as a record of payment. You can also make payments via the internet. Go to www. revenue. louisiana*gov* Name In order as listed on tax return Address Your Social Security Number 1 City State ZIP Your spouse s Social Security Number 2 Amount of payment Check number Date sent Detach and submit the voucher below with your payment by May 17 2004. Name Address For office use only. 62222 Make payment to Louisiana Department of Revenue Do not send cash.

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Keywords relevant to Form R 54ov Sd

  • taxpayer
  • detach
  • electronically
  • Voucher
  • Penalties
  • retained
  • enclosed
  • spouse
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