Form R-2868v "Individual Income Tax Electronically Filed Extension Payment Voucher" - Louisiana

Form R-2868V is a Louisiana Department of Revenue form also known as the "Individual Income Tax Electronically Filed Extension Payment Voucher". The latest edition of the form was released in January 1, 2019 and is available for digital filing.

Download a PDF version of the Form R-2868V down below or find it on Louisiana Department of Revenue Forms website.

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R-2868V (1/19)
Louisiana Department of Revenue
Individual Income Tax
P.O. Box 751
Electronically Filed Extension Payment Voucher (2018)
Baton Rouge, LA 70821-0751
IMPORTANT NOTICE: The voucher below must accompany payments made by individuals that have filed their extension request
electronically and did not submit their payments through electronic funds transfer.
This voucher is NOT a request for an extension of time to file a return or an extension of time to pay the tax due. You must still submit
a separate extension request. An extension will not be granted if a payment is made using this form. Payments received after the return
due date will be assessed interest and late payment penalty. You can make payments electronically at www.revenue.louisiana.gov/latap.
Louisiana Individual Income Tax Extension Payment
Enter your total Louisiana income tax liability for the tax year ended December 31,
1
1
2018, or the fiscal year ended ________, 2019.
.00
(You may estimate this amount.)
2
Enter total Louisiana income tax withheld.
2
.00
Enter total amount of declaration/estimated payments, credit carried forward from
3
3
previous year, and any composite partnership payments made on your behalf.
.00
4
Enter total payments
4
(Add lines 2 and 3.)
.00
Enter income tax balance due.
(Subtract Line 4 from Line 1. If Line 4 is greater than Line
5
5
1, enter zero “0.”)
.00
2
4
6
8
10
12
14
16
18
20
22
24
26
28
30
32
34
36
38
40
42
44
46
48
50
52
54
56
58
60
62
64
66
68
70
72
74
76
78
80
82
84
Detach and submit the voucher below with your payment.
18
R-2868V (1/19)
For calendar year ended 2018, or other tax year beginning ___________, 2018, ending ____________, 2019.
46
Individual Income Tax Electronically Filed Extension Payment Voucher
48
First Name, Middle Initial, and Last Name
Your Social Security Number
50
Spouse’s First Name, Middle Initial, and Last Name
Spouse’s Social Security Number
52
Address
54
City, Town, or APO
State
ZIP
56
Amount
u
enclosed
Mail this voucher with your payment to:
58
Louisiana Department of Revenue
DO NOT SEND CASH
P.O. Box 751
60
Baton Rouge, LA 70821-0751
1904
62
19042
651
12312018
64
R-2868V (1/19)
Louisiana Department of Revenue
Individual Income Tax
P.O. Box 751
Electronically Filed Extension Payment Voucher (2018)
Baton Rouge, LA 70821-0751
IMPORTANT NOTICE: The voucher below must accompany payments made by individuals that have filed their extension request
electronically and did not submit their payments through electronic funds transfer.
This voucher is NOT a request for an extension of time to file a return or an extension of time to pay the tax due. You must still submit
a separate extension request. An extension will not be granted if a payment is made using this form. Payments received after the return
due date will be assessed interest and late payment penalty. You can make payments electronically at www.revenue.louisiana.gov/latap.
Louisiana Individual Income Tax Extension Payment
Enter your total Louisiana income tax liability for the tax year ended December 31,
1
1
2018, or the fiscal year ended ________, 2019.
.00
(You may estimate this amount.)
2
Enter total Louisiana income tax withheld.
2
.00
Enter total amount of declaration/estimated payments, credit carried forward from
3
3
previous year, and any composite partnership payments made on your behalf.
.00
4
Enter total payments
4
(Add lines 2 and 3.)
.00
Enter income tax balance due.
(Subtract Line 4 from Line 1. If Line 4 is greater than Line
5
5
1, enter zero “0.”)
.00
2
4
6
8
10
12
14
16
18
20
22
24
26
28
30
32
34
36
38
40
42
44
46
48
50
52
54
56
58
60
62
64
66
68
70
72
74
76
78
80
82
84
Detach and submit the voucher below with your payment.
18
R-2868V (1/19)
For calendar year ended 2018, or other tax year beginning ___________, 2018, ending ____________, 2019.
46
Individual Income Tax Electronically Filed Extension Payment Voucher
48
First Name, Middle Initial, and Last Name
Your Social Security Number
50
Spouse’s First Name, Middle Initial, and Last Name
Spouse’s Social Security Number
52
Address
54
City, Town, or APO
State
ZIP
56
Amount
u
enclosed
Mail this voucher with your payment to:
58
Louisiana Department of Revenue
DO NOT SEND CASH
P.O. Box 751
60
Baton Rouge, LA 70821-0751
1904
62
19042
651
12312018
64
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