Louisiana Estimated Tax Declaration Voucher For

42 86 8482807876747270686664626058565452504846444240383634323028262422201816141210

LOUISIANA ESTIMATED TAX DECLARATION VOUCHER FOR INDIVIDUALS – 2021 For calendar year 2021 or fiscal year ending ______IT-540ES WEB (2021) year I Your Social Security Number Spouse’s Social Security Number Payment Due Date Individual Voucher 1 Amount of payment (DO NOT SEND CASH) Address changes and estimated tax payments can be made at www.revenue.louisiana.gov/latap. To ensure proper credit, please DO NOT fold or staple. $ .00 Mail this form with your payment to: Louisiana Department of Revenue P.O. Box 91007 Name Baton Rouge LA 70821-9007 Spouse’s Name Address City, State ZIP 1905 Mail date

19059 600 12312021 For office use only 42 86 8482807876747270686664626058565452504846444240383634323028262422201816141210

LOUISIANA ESTIMATED TAX DECLARATION VOUCHER FOR INDIVIDUALS – 2021 For calendar year 2021 or fiscal year ending ______IT-540ES WEB (2021) year I Your Social Security Number Spouse’s Social Security Number Payment Due Date Individual Voucher 2 Amount of payment (DO NOT SEND CASH) Address changes and estimated tax payments can be made at www.revenue.louisiana.gov/latap. To ensure proper credit, please DO NOT fold or staple. $ .00 Mail this form with your payment to: Louisiana Department of Revenue P.O. Box 91007 Name Baton Rouge LA 70821-9007 Spouse’s Name Address City, State ZIP 1905 Mail date

19059 600 12312021 For office use only 42 86 8482807876747270686664626058565452504846444240383634323028262422201816141210

LOUISIANA ESTIMATED TAX DECLARATION VOUCHER FOR INDIVIDUALS – 2021 For calendar year 2021 or fiscal year ending ______IT-540ES WEB (2021) year I Your Social Security Number Spouse’s Social Security Number Payment Due Date Individual Voucher 3 Amount of payment (DO NOT SEND CASH) Address changes and estimated tax payments can be made at www.revenue.louisiana.gov/latap. To ensure proper credit, please DO NOT fold or staple. $ .00 Mail this form with your payment to: Louisiana Department of Revenue P.O. Box 91007 Name Baton Rouge LA 70821-9007 Spouse’s Name Address City, State ZIP 1905 Mail date

19059 600 12312021 For office use only 42 86 8482807876747270686664626058565452504846444240383634323028262422201816141210

LOUISIANA ESTIMATED TAX DECLARATION VOUCHER FOR INDIVIDUALS – 2021 For calendar year 2021 or fiscal year ending ______IT-540ES WEB (2021) year I Your Social Security Number Spouse’s Social Security Number Payment Due Date Individual Voucher 4 Amount of payment (DO NOT SEND CASH) Address changes and estimated tax payments can be made at www.revenue.louisiana.gov/latap. To ensure proper credit, please DO NOT fold or staple. $ .00 Mail this form with your payment to: Louisiana Department of Revenue P.O. Box 91007 Name Baton Rouge LA 70821-9007 Spouse’s Name Address City, State ZIP 1905 Mail date

19059 600 12312021 For office use only