Installment Payment AgreementDepartment of Revenue 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Business Legal Name and LDR Revenue Account Number at the top of the form. Ensure all information is accurate.
3. Fill in your Business Mailing Address, including Unit Type, City, State, and ZIP code. This ensures that all correspondence reaches you promptly.
4. Select your Applicant(s) Legal Structure from the options provided (e.g., Corporation, LLC). This helps categorize your business type for tax purposes.
5. Provide contact details including a Contact Name and Office Phone number for any follow-up communication regarding your request.
6. Detail the Description of Tax Type to be included in the Installment Request. Mark all applicable tax types and provide corresponding amounts due.
7. Indicate your requested payment amount and frequency (weekly, biweekly, or monthly). Be realistic about what you can afford to pay.
8. Finally, sign and date the form under penalties of perjury to affirm that all information is true and complete before submitting it through your preferred method.

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