Form R-210 - Underpayment Of Individual Income Tax Penalty Computation Taxable Year Resident Filers - 2003

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State of Louisiana
2003
R-210 (01/04)
Department of Revenue
Underpayment of Individual Income Tax Penalty Computation
2003 Taxable Year Resident Filers
Name(s) shown on tax return
Social Security Number(s)
Your name _________________________________________________________________________
Yours __________________________
Spouse ____________________________________________________________________________
Spouse’s _______________________
Section 1 – Amount of required annual payment
1. Required amount of 2003 tax liability
.00
2. Required amount of 2002 tax liability
.00
3. Enter the smaller of Line 1 or Line 2
.00
4. Number of payments required for year
Section 2 – Underpayment Computation
04/15/03
06/16/03
09/15/03
01/15/04
5. From Section 1, divide Line 3 by Line 4.
.00
.00
.00
.00
6. Enter amounts paid – See instructions.
.00
.00
.00
.00
7. Overpayment of installment – See instructions.
Any overpayment in the second, third, or fourth
periods may not be carried back to a previous
period.
.00
.00
.00
.00
8. Adjust payments to account for
any carryforward
.00
.00
.00
.00
9. Underpayment (Line 5 less Line 8) or
Overpayment (Line 8 less Line 5)
.00
.00
.00
.00
Section 3 – Exceptions
10. Exception 1 – See worksheet on page 3. If you meet this exception, you do not owe an underpayment penalty.
STOP – You do not need to file this form.
04/15/03
06/16/03
09/15/03
01/15/04
11. Exception 2 – Prior Year’s Tax Liability
12. Exception 3 – Prior Year’s Income
13. Exception 4 – Annualized Income
no exception available
14. Exception 5 – Installment Period Income
Section 4 – Penalty Computation
04/15/03
06/16/03
09/15/03
01/15/04
15. Amount of underpayment (from Line 9 above)
.00
.00
.00
.00
16. Date of Payment – See instructions.
17. Number of days from due date of installment
18. Penalty – See instructions.
.00
.00
.00
.00
19. Penalty – Add amounts on Line 18. Enter total
here and on Line 4 of the Interest and Penalty
Calculation Schedule on Form IT-540
.00

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