Sales And Use Tax Report Worksheet / Taxpayer Copy Page 2
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1
2WORKSHEET / TAXPAYER COPY
Revenue Account Number
Location Address
Month / Quarter Ending
City of B. R.
Parish of EBR
Parish of EBR
City of Baker
City of Baker
City of Zachary
City of Central
EBRP School Dist. EBRP School Dist.
Zach. School Dist
Baker School Dist
EBRP School Dist
Zach. School Dist
EBRP School Dist.
5%
5%
5%
5.5%
5.5%
5%
5%
1.
Gross Sales as Reported to the State of LA
00
00
00
00
00
00
00
Allowable Deductions
2.
Sales for resale (resale certificate on file)
00
00
00
00
00
00
00
3.
Cash discounts, sales returns & allowances
00
00
00
00
00
00
00
4.
Sales delivered or shipped outside
this jurisdiction
00
00
00
00
00
00
00
5.
Sales of gasoline and motor fuels
00
00
00
00
00
00
00
6.
Sales to the U.S. Government, State of LA
and local government agencies
00
00
00
00
00
00
00
7.
Sales of Food Paid with USDA Food Stamps,
and WIC Stamps or Cards
00
00
00
00
00
00
00
8.
Other deductions (Explain Briefly)
00
00
00
00
00
00
00
9.
Other deductions (Explain Briefly)
00
00
00
00
00
00
00
10.
Other deductions (Explain Briefly)
00
00
00
00
00
00
00
11.
Total Allowable Deductions
(Sum of Lines 2 - 10)
00
00
00
00
00
00
00
12.
Adjusted Gross Sales
00
00
00
00
00
00
00
(Line 1 minus Line 11)
13.
FOR OFFICE USE ONLY
14.
Purchases Subject to Use Tax
00
00
00
00
00
00
00
15.
Total Taxable Transactions
(Line 12 + Line 14)
00
00
00
00
00
00
00
16.
Tax (Rates under the Column Heading)
(5% or 5.5% of Line 15)
00
00
00
00
00
00
00
16(a). Sales of Food for Home Consumption,
Prescription Drugs, & Medical Devices
00
00
00
00
00
00
00
16(b). Amount Deductible (2% of Line 16(a)
for Sales of Food , Drugs, & Medical Items)
00
00
00
00
00
00
00
16(c). Amount Deductible (1% of Line 16(a)
for Sales to Qualified Contractors)
00
00
00
00
00
00
00
16(d). Net Tax Due
(Line 16(a) less 16(b) or 16(c))
00
00
00
00
00
00
00
17.
Excess Tax collected
00
00
00
00
00
00
00
18.
Total Tax Due (Line 16(d) + Line 17)
00
00
00
00
00
00
00
19.
Vendor's Compensation (current returns only)
(1% of Line 18)
00
00
00
00
00
00
00
00
00
00
00
00
00
00
20.
Net Tax Due ( Line 18 minus Line 19)
00
00
00
00
00
00
00
21.
Penalty (5% per month up to 25%)
00
00
00
00
00
00
00
22.
Interest (15% per annum)
23.
Total Tax, Penalty, & Interest Due
(Sum of Lines 20 - 22)
00
00
00
00
00
00
00
24.
FOR OFFICE USE ONLY
00
00
00
00
00
00
00
25.
Total Amount Due (Line 23 + Line 24)
26.
Remittance (Total of Line 25,
Columns A, B, C, D, E, F, & G)
00
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