Sales / Use Tax Report Form - Parish Of Terrebonne
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1PARISH OF TERREBONNE
Sales and Use Tax Department
Sales and Use Tax Report
To avoid penalties this return should be
transmitted on or before
the 20th of each month following the
period covered.
TO FILE AND PAY ONLINE:
parishe-file.revenue. louisiana .gov
THIS RETURN DUE ON THE 1ST
DAY OF THE MONTH FOLLOWING
PERIOD COVERED BY THE
RETURN AND BECOMES
DELINQUENT ON 21ST DAY.
PERIOD COVERED
2
3
4
5
6
7
a
9
10
Gross sales of tangible personal property, leases, rentals, and
services as reported to the State of Louisiana.
ALLOWABLE DEDUCTIONS
Sales for resale.
Cash discounts, sales returns, & allowances.
Sales delivered or shipped outside this parish.
Sales of gasoline and motor fuels.
Sales to U.S. Gov't., State of LA & its political sub.& agencies
Food
paid for with USDA food stamps or WIG vouchers.
OTHER DEDUCTIONS Authorized By Law. (explain briefty)
11 Total allowable deductions Cline 2 thru 10).
COMPUTATION OF SALES AND USE TAX
12. ADJUSTED GROSS SALES (Line 1 minus line 11
l
13.
14. PURCHASES SUBJECT TO USE TAX IN TERREBONNE PARISH
15. TOTAL (Line 12 olus line 14)
16. TAX
(5.5%
OF LINE 15)
17. EXCESS TAX COLLECTED
18. TOTAL (Line 16 olus line 17)
19. VENDOR'S COMPENSATION
<2%
of line 18 - deductible onlv when payment is not delinquent)
20. NET TAX DUE (Line 18 minus line 19)
PLEASE INDICATE ANY CHANGES BELOW
Date Out-Of-Business
Date Business Sold
I
Name
of
Purchaser
Mailing Address Change
Location Address Change
Change in Name of Business
~II
21
DELINQUENT PENAL TY
(5%
of tax on the date the return becomes delinquent, with an addrtional
5%
for each subsequent 30-day period, not to exceed
25%
in the aggregate)
22. INTEREST 1.0329% of tax oer dav from the first dav of the month following period covered by the return, until paid)
23. TOTAL TAX, PENALTY AND INTEREST DUE
24. TAX DEBIT OR CREDIT (AUTHORIZED MEMO MUST BE ATTACHED)
25. TOTAL AMOUNT DUE (Line 23 plus or minus line 24)
I declare under the penalties for filing false reports that this return (including any accompanying schedules and statements) has been
examined by me and to the best
of
my knowledge and belief is a true, correct, and complete return If the return is prepared by a person
other than the taxpayer, his declaration is based on all the information relating to the matters required to be reported in the return of
which he has any knowledge.
AUTHORIZED SIGNATURE
DATE
WARNING:
DO
NOT USE ANY OTHER TAXPAYER'S
RETURN AS THIS WILL RESULT IN IMPROPER CREDIT
MAKE SURE return and check is dated and signed
Make all remittances payable to PARISH SALES TAX FUND
SIGNATURE OF PREPARER OTHER THAN TAXPAYER
MAIL TO:
Terrebonne Parish Sales
&
Use Tax Dept.
P.O. Box670
Houma,
LA
70361-0670
LOUISIANA TAX IDENTIFICATION NO:
DATE
REVIEWED BY
FOR TAXPAYER ASSISTANCE CONTACT:
985-876-3734
985-876-9841
PHONE
FAX
EMAIL
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