R-541V (1/21) 

                                     Fiduciary Income Tax Electronic              Louisiana Department of Revenue
                                                                                  P.O. Box 3550
                                     Filing Payment Voucher (2020)                Baton Rouge, LA  70821-3550

IMPORTANT NOTICE
Taxpayers who file electronically and owe additional Louisiana fiduciary income tax for 2020 must complete the payment
voucher at the bottom of this form, detach the voucher, and mail it with payment by May 15, 2021, in order to avoid the
assessment of penalties and interest.

  • DO NOT SEND CASH.
  •  Complete and retain this portion as a record of payment.
  •  You can also make payments via the internet. Go to         www.revenue.louisiana.gov/latap
  • Complete the voucher below. If you have a foreign address, enter the city name in the appropriate 
     space. Follow the country’s practice for entering the postal code and the name of the province, county, 
     or state. Enter the foreign country name in the appropriate space. Don’t abbreviate the country name.

Name of Estate or Trust                                               LDR Account Number

Name of Fiduciary or Trustee                                          Tax Period

Amount of payment                    Check Number                                 Date Sent
$                            .

Detach and submit the voucher below with your payment by May 15, 2021. You must enter your LA Revenue Account Number below.

R-541V (1/21)                                                                                  2020 FI
                             Fiduciary Income Tax Electronic Filing Payment Voucher
Name of Estate or Trust                                              LDR Account Number

Name of Fiduciary or Trustee                                         Filing Period

Address                                                                           Unit Type    Unit Number

City                                                 State ZIP       Foreign Nation, if not United States (do not abbreviate)

                                                                      Amount 
                                                                     enclosed u   $                       .
                                                                                       DO NOT SEND CASH
                                     Make payment to:
                                     Louisiana Department of Revenue
                                     P. O. Box 3550                          Mail date
                                     Baton Rouge, LA 70821-3550                                1903
                                     Please include your LDR Account 
                                     Number on your payment.          For office use only

        19034                        691 12312020