Revised 12/2023

                              FORM E-11 EARNINGS TAX PRE-PAYMENT VOUCHER

Account number (SSN or FEIN)                                                           ⬜✔   E-1 (individual wage earner)

Name                                                                                   ⬜✔  E-234 (sole proprietor, independent contractor,

Address                                                                                     corporation, partnership, or other business)

City/State/ZIP

Tax period ending

Pre-payment amount           $

Make checks payable to:                                                                                      Pre-pay your Earnings Tax online!

Gregory F.X. Daly, Collector of Revenue                                                                Visit pay.payitgov.com/stlearningstax

Mail to:                                                                                                     or scan the QR code below

Earnings Tax Division

1200 Market Street, Room 410

St. Louis, MO 63103

Important Information                                                         Form Intructions
Form E-11 is used to make voluntary payments towards Earnings Tax filed       Account number: Enter your Social Security Number or Federal Employer 
on  Form  E-1  or  E-234. Payments  submitted  using  Form  E-11  do  not     Identification Number.
eliminate the need to file actual tax returns.                                Name: For E-1 filers, enter your legal individual name. For E-234 filers, enter 
                                                                              your legal business name.
E-234  filers  wishing  to  file  an  extension  must  submit  Form  E-8.     Address: Enter your current mailing address.
Payments made using this form alone do not provide an extension of time       Tax period ending:  For  E-1  filers,  enter  the  calendar  year  to  which  you 
to file.                                                                      would like this payment applied. For E-234 filers, enter either the calendar 
                                                                              year or the last date of the fiscal year to which you would like this payment 
Pre-payments  must  be  received  prior  to  the  due  date  of  the  return. to be applied.
Amounts received with Form E-11 after the due date of the return may be       Pre-payment amount: Enter the amount remitted with this form.
applied to fees, penalties, and/or interest.