Sales And Use Tax Report Form - State Of California
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1
2S A L E S
A N D
U S E
T A X
REPORT
City of Baton Rouge - Parish of East Baton Rouge
Account Number:
Dept. of Finance -Revenue Division
P.O. Box 2590
Filing Period
Baton Rouge, LA 70821-2590
Fax 225-389-5369
Phone 225-389-3084
A
B
C
City of Baton Rouge
Parish of EBR
Parish of EBR
EBRP School District
EBRP School District
Zachary School District
Round All Numbers and Your
Check to the Nearest Dollar.
5.00%
5.00%
DO NOT USE CENTS.
5.00%
,
,
,
,
,
,
Gross Sales as Reported to the State of LA
1
Deductions:
,
,
,
,
,
,
2
Sales for Resale
,
,
,
,
,
,
3
Cash Discounts, Returns, & Allowances
,
,
,
,
,
,
4
Sales Delivered Outside this Jurisdiction
,
,
,
,
,
,
5
Sales of Gasoline and Motor Fuels
6
Sales to the U.S. Government, State of LA,
,
,
,
,
,
,
and local governmental agencies
Sales of Food Paid with USDA Food
7
,
,
,
,
,
,
Stamps and WIC Stamps or Cards
8
Other (Explain Briefly)
,
,
,
,
,
,
9
Other (Explain Briefly)
,
,
,
,
,
,
10
Other (Explain Briefly)
,
,
,
,
,
,
11
Total Allowable Deductions (sum
,
,
,
,
,
,
of lines 2 - 10)
12 Adjusted Gross Sales (Line 1 minus Line 11)
,
,
,
,
,
,
13 FOR OFFICE USE ONLY
,
,
,
,
,
,
14 Purchases Subject to Use Tax
15 Total Taxable Transactions
,
,
,
,
,
,
(Line 12 plus Line 14)
16
Tax (5.00% of Line 15, except 5.50%
,
,
,
,
,
,
for columns D & E, see instructions)
16a
Sales of Food, Drugs, Medical Items,
,
,
,
,
,
,
and Materials/Supplies to Contractors
16b
Food, Drug, Medical Item Deductible (2.00% of
,
,
,
,
,
,
Line 16a except 1.00% Column E)
16c
Amount Deductible (1.00% of Line 16a
,
,
,
,
,
,
for Sales to Qualified Contractors)
16d
Net Tax Due (Line 16 less
,
,
,
,
,
,
Line 16b less 16c)
17
,
,
Excess Tax Collected
,
,
,
,
18
Total Tax Due (Line 16
,
,
,
,
,
,
(d) plus Line 17)
19
Vendor's Compensation
,
,
,
,
,
,
(1% of Line 18)
20
Net Tax Due (Line 18
,
,
,
,
,
,
minus Line 19)
21
PENALTY
,
,
,
,
,
,
22
,
,
INTEREST
,
,
,
,
23
Total Tax, Penalty, and Interest
,
,
,
,
,
,
(Sum of Lines 20 through 22)
24
FOR OFFICE USE ONLY
,
,
,
,
,
,
Total Amount Due (Line 23 + Line 24)
25
26
Remittance (Total of Line 25, Columns A, B, C, D, E, & F)
MAKE REMITTANCE PAYABLE TO PARISH AND
CITY TREASURER
,
,
WARNING: DO NOT USE ANOTHER
This return is DUE on the 1st day of the month following the period covered by this
TAXPAYER'S RETURN AS THIS WILL
return and becomes DELINQUENT if not received by this office prior to the 21st day.
RESULT IN IMPROPER CREDIT.
Business Name
For Office Use Only:
Address
Postmark Date
1
Transaction Code
City, State, Zip
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