Form R-5702-L - Telecommunications Tax For The Deaf
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R-5702-L (7/07)
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If your name has
If your address has
If amended return,
If final return,
changed, mark circle.
changed, mark circle.
mark circle.
mark circle.
Telecommunications Tax
for the Deaf
Louisiana Department of Revenue
Excise Section
Account Number >
P.O. Box 201
Name(1) >
Baton Rouge, LA 70821-0201
Taxpayer Services Division
Name(2) >
(225) 219-7656
Address(1) >
(225) 219-2114 (TDD)
Address(2) >
City, State, ZIP >
Taxable
T T L L
period
Please return this copy.
A
B
C
D
First month
Second month
Third month
Totals for quarter
of quarter
of quarter
of quarter
(Columns A + B + C)
1
1
Total number local telephone access lines
2a Less:
a) U.S. Government lines
2a
2b
b) Other exempt lines
2b
(Subtract Lines 2a and 2b in
3
Access lines subject to tax
3
each Column from Line 1.)
4
TAX DUE (Multiply amount on Line 3 by $.05.)
4 $
5
Less: Vendor's Compensation (2% of Line 4 if not delinquent.)
5 $
6
NET TAX DUE (Subtract Line 5 from Line 4.)
6 $
(5% of tax for each 30 days
7
7 $
Delinquent penalty
delinquent, not to exceed 25%.)
8
8 $
Interest (See instructions.)
9
Total penalty and interest (Add Line 7 plus Line 8.)
9 $
Make check payable to Louisiana
PAY THIS
➤
10 TOTAL AMOUNT DUE
10 $
(Add Line 6 plus Line 9.)
Department of Revenue. Do not send cash.
AMOUNT.
•
To avoid penalties, return must be transmitted on or before the 30th day following the period covered.
•
Under the penalties of perjury, I declare that I have examined this return, including all accompanying documents, and to the
best of my knowledge and belief, it is true, correct, and complete.
Date (MM/DD/YYYY)
Signature
Telephone
Date (MM/DD/YYYY)
Signature of paid preparer
Telephone
General Instructions
1
Effective September 1, 1988, every local telephone exchange company is to collect a tax monthly from each residential and business
customer. The tax, based on the customer's two-way telephone access lines, is to be remitted quarterly with the return and is due on
or before the 30th day following the close of the reporting period.
2
Corrections to the name and/or address information appearing on the label should be made by drawing a line through the incorrect
information and adding the correct information.
3
Care should be exercised to ensure that (a) the correct period is indicated on the return; (b) the return is signed and dated; (c) a
payment of the full amount due accompanies the return; and (d) the return and payment is placed in a properly addressed stamped
envelope and mailed to the Louisiana Department of Revenue.
8601
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