Form R-19025 - Installment Request For Individual Income Page 2
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2R-19025 (9/02)
Scheduled payments are due on the 15th of each month. Penalty and interest will continue to accrue until the balance
of tax is paid in full.
In order to calculate the six (6) monthly installment payments, subtract the 20% down payment from the total tax due on Form
IT-540.
Tax Due
$ ___________________________
Less down payment (20%) $ ___________________________
Balance
$ ___________________________
Divide the balance due by six (6) to determine the monthly installment payment.
Installments:
Six installments of $ _________________ each.
Please contact the Collection Division at (225) 219-7448 for a final installment of any tax and/or accrued interest and penalties.
Payments are due on the 15th of each month.
The normal billing process will continue. A part of that process is the issuance of a Final Notice Before Seizure. Failure to make
the scheduled monthly payment will result in seizure of bank accounts and/or garnishment of your wages. Please
ensure that your social security number is written on your remittance.
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