R-1029 (7/13)
Louisiana Department of Revenue
Sales Tax Return
Location address:
Address
City
State
ZIP
Account Number
If address is differ-
*
ent from that shown,
Name(1)
mark here and make
corrections in area
*
provided on back.
Name(2)
*
Address(1)
*
Do not use this form
*
Address(2)
for filing periods
prior to July 2013.
City
State
ZIP
Filing period
mm/yy
Please use blue or black ink.
U.S. NAICS
Code
Round to the nearest dollar. Do not use dashes.
,
,
.
00
1 Gross sales of tangible personal property ..................................................... 1
2 Cost of tangible personal property
,
.
,
00
(Used, consumed, or stored for use or consumption, or purchased
............................................ 2
or imported to be sold in coin-operated vending machines)
,
,
.
3 Leases, rentals, and services
00
(Do not include motor vehicle leases
..................................... 3
or rentals, which must be filed electronically. See instructions.)
,
,
.
00
4 Total
................................................................................. 4
(Add Lines 1 through 3.)
,
,
.
5 Total allowable deductions
00
(From Line 34, Schedule A. Do not include as a
.) ................................................ 5
deduction any item not reported on Lines 1 through 3
.
,
,
00
6 Amount taxable
....................................................... 6
(Subtract Line 5 from Line 4.)
,
,
.
00
7 Tax due
............................................................. 7
(Multiply amount on Line 6 by 4%.)
,
,
.
00
8 Excess tax collected
............................................. 8
(Do not include local sales tax.)
.
,
,
00
9 Total
................................................................................. 9
(Add Line 7 and Line 8.)
,
,
.
00
10 Vendor’s compensation
.................................. 10
(.935% of Line 9 if not delinquent)
,
,
.
00
11 Gross tax due
....................................................... 11
(Subtract Line 10 from Line 9.)
,
,
.
12A Register reprogramming credit
(Actual programming costs, not to
00
................................................12A
exceed $25 per register - invoices must be attached)
,
,
.
13 Net tax due
(Subtract Line 12A from Line 11.
00
................................................... 13
If Line 12A exceeds Line 11, please see instructions.)
,
,
.
13A Donation to The Louisiana Military Family Assistance Fund
00
............................................13A
(Enter the amount from Line 35 from the back of the return.)
,
.
,
00
14 Penalty
..................................................................................... 14
(See instructions.)
,
,
.
00
15 Interest
.................................................................................... 15
(See instructions.)
16 Total payment due
(Add Lines 13, 13A, 14, and 15.)
Mark this box if payment
Make payment to: Louisiana Department of Revenue.
made electronically.
,
,
.
00
PAY THIS AMOUNT
(DO NOT SEND CASH.) u
...... 16
,
.
,
00
17 Overpayment to be refunded ......................................................................... 17
(Add Lines 11 and 13A and subtract Line 12A. Do not claim a credit for this overpayment
on any other return.) If final or amended return, mark boxes on back of this form.
WEB
SPEC
CODE
4316