State of Los Angeles Department of Revenue
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Los Angeles Tax Payment Form
Tax Payment - Personal Information
Full Name
Social Security Number (SSN)
Date of Birth
Mailing Address
Physical Address (if different)
Filing Status
-- Select Filing Status --
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er)
Dependents (if any)
Income Amount ($)
Upload ID (Driver's License, Passport, etc.)
Purpose of Filing
-- Select Purpose --
Income Tax Payment
Business Tax Payment
Penalty / Late Fee
Other
Employment Status
-- Select Employment Status --
Employed
Self-Employed
Unemployed
Retired
Student
Source of Income
Submit Tax Information