FORM:  E-11                ANNUAL ST LOUIS CITY EARNINGS TAX              Rev.  02/10                                        
                                                                                                                           
                               (Please Indicate Account Type) 
                                            
           E-1 (W-2 Wage Earners)                                  E-234 (Business Accounts) 
                                            
1. ACCOUNT NUMBER (SSN OR EIN): ____________________________________ 
2. NAME:  _____________________________________________________________ 
3. DBA   (E-234 Filers Only):  _________________________________________________   
4. ADDRESS:  __________________________________________________________ 
5. CITY, STATE & ZIP CODE: ____________________________________________ 
6. TAX PERIOD ENDING:  ________________    7.   AMOUNT: $_______________ 
 
                               MAKE CHECKS PAYABLE TO:   
                GREGORY F.X. DALY - COLLECTOR OF REVENUE 
                               MAIL TO:  
                                EARNINGS TAX DIVISION 
          1200 MARKET ST. – ROOM 410 CITY HALL – ST. LOUIS, MO.  63103  
                                            
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                               INSTRUCTIONS 
 
 THIS IS FOR VOLUNTARY ESTIMATED PAYMENTS TOWARDS AN ANNUAL E-1 OR E-234 TAX FILING. 
                                            
  PAYMENTS DO NOT ELIMINATE THE NEED TO FILE ACTUAL TAX RETURNS.   
 
1. ENTER YOUR EARNINGS TAX ACCOUNT NUMBER ON LINE 1 (THIS WILL BE EITHER YOUR 
   SOCIAL SECURITY OR FEDERAL EIN NUMBER). 
2. ENTER YOUR NAME (PERSONAL NAME / E-1) OR (BUSINESS NAME / E-234) ON LINE 2. 
3. E-234 FILERS - ENTER DBA (DOING BUSINESS AS) IF APPLICABLE ON LINE 3. 
4. ENTER YOUR STREET ADDRESS ON LINE 4. 
5. ENTER CITY, STATE & ZIP CODE ON LINE 5. 
6. ENTER THE TAX PERIOD THAT THE PAYMENT NEEDS TO BE APPLIED TO ON LINE 6. 
7. ENTER THE AMOUNT OF PAYMENT ON LINE 7. 
8. THESE PAYMENTS ALONE DO NOT PROVIDE AN EXTENSION FOR E-234 TAX FILERS.  A REQUEST 
   USING FORM E-8 MUST BE SUBMITTED TO THE COLLECTOR OF REVENUE SEPARATE FROM & IN 
   ADDITION TO A FEDERAL EXTENSION REQUEST MADE WITH THE IRS. 
9. E-234 TAX FILERS ARE TO PUT TOTAL ESTIMATED PAYMENTS ON LINE 13 OF FORM E-234.   
    
                           TAX FORMS ARE AVAILABLE ON OUR WEBSITE AT: 
                               www.stlouiscollector.com 
                                            
                           Office Hours: 8:00 a.m. to 5:00 p.m.  -  Monday thru Friday