Account No:
Jefferson Parish General Sales
Bureau of Revenue and Taxation
Sales and Use Tax Return
Location:
PO BOX 248
GRETNA, LA 70054-0248
November
2011
Month Ending:
Amended Return
12/20/2011
Delinquent on
Calculate
Change of Address
Column A
4.750 %
General Sales
01
Gross Sales
Sales for Resale or Further Processing
02
03
Cash Discounts / Sales Returns
04
Sales outside this Jurisdiction
05
Sales of gasoline
Sales to Government Agencies
06
Food Stamp/WIC Sales (Column A Only)
07
Other Deductions
08
09
Other Deductions
Other Deductions
10
0.00
11
Total Deductions
13
Taxable Sales (Line 1 Minus Line 11)
0.00
14
Purchases Subject to Use Tax
Total Subject to Tax (Line 13 Plus Line 14)
15
0.00
16
Tax Calculations (Multiply Line 15
0.00
by % for Column)
17
Excess Tax collected
18
Total (Line 16 plus Line 17)
0.00
19
Vendor's compensation
0.00
(1% of Line 18 when not delinquent)
20
Net Tax Due (Line 18 minus Line 19)
0.00
21
Penalty (5% for each 30 days or fraction
0.00
thereof not to exceed 25%)
22
Interest (1% from due date until paid)
0.00
23
Total Tax, Penalty and Interest Due
0.00
(Add Lines 20, 21, and 22)
24
Tax Debit or Credit
(Authorized Memo MUST be Attached)
25
Total Owed (Line 23 plus or minus Line 24)
0.00
26
TOTAL TO BE REMITTED (Make Checks payable to Newell Normand, Sheriff and Tax Collector)
$0.00
I swear (or affirm) that the information on this sales and use tax return has been examined by me and is true and correct.
Date:
Signature of Taxpayer
Title
Preparer Signature
Form
0001 T
Office Use Only