Form 8144 Jpso Application - Bureau Of Revenue And Taxation Page 2

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OCCUPATIONAL LICENSE SCHEDULE “A”

Check and complete only one of 18 through 21

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18. Business opened within prior 30 days

A. Business opened between December 2nd and December 31st

Gross receipts for the remainder of calendar year: $ ______________

Locate tax due from applicable rate table and enter on line 22 below.

B. Business opened less than 30 days (excl. period December 2nd to December 31st)

The tax due will be the minimum of applicable rate table. Enter on line 22 below.

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19. Business opened more than 30 days

Gross receipts for first 30 days: $ ______________

Less deductions (describe): ____________________________________ $ ______________ equals $ ______________ which

multiplied by the number of months, or major fraction thereof, remaining in the year ____ amount to a tax basis of $ ___________.

Locate tax due from applicable rate table and enter on line 22 below.

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20. Business opened during previous calendar year

Gross sales for remainder of calendar year: $ ______________

Less deductions (describe): ____________________________________ $ ______________ equals $ ______________ which

divided by the number of days in operation _____ which multiplied by 365 amounts to a tax basis of $ ______________.

Locate tax due from applicable rate table and enter on line 22 below.

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21. Business opened on or prior to January 1st of the previous year

Gross sales for the calendar year: $ ______________

Less deductions (describe): __________________________________ $ _____________ equals a tax basis of $ _____________.

Locate tax due from applicable rate table and enter on line 22 below.

22. LICENSE FEE/RATE BASED ON TABLE #: ___________ ..............................................................................$ _______________________

23. To be used by those occupations paying a fee based on units, indicate number

of seats, spaces, pool tables, etc.

Fee

Total For

Item

Number

Per Item

This Item

TOTAL BASED ON UNITS ............................$ _______________________

24. Chain store tax due (as calculated from chain store tax schedule on page 8) ................................................$ _______________________

25. Amount of tax due (add lines 22, 23, and 24) ..................................................................................................$ _______________________

26. Penalty................................................................................................................................................................$ _______________________

27. Interest ...............................................................................................................................................................$ _______________________

28. Total amount due ..............................................................................................................................................$ _______________________

FOR OFFICE USE ONLY

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If located in unincorporated Jefferson Parish, is zoning clearance attached?

Yes

Account #: _____________________

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In compliance with trade name recordation requirement?

Yes

(If no, amend trade name accordingly)

License Yr.: ____________________

This business will be coded for the following:

License Code: __________________