Sales And Use Tax Return - Parish Of Terrebonne

PARISH OF TERREBONNE

SALES AND USE TAX DEPARTMENT

P.O. Box 670

Houma, LA 70361-0670

RETURN SERVICE REQUESTED

PARISH OF TERREBONNE

PRESORTED

STANDARD

US POSTAGE PAID

HOUMA, LA

PERMIT NO. 147

SALES AND USE TAX RETURN

MONTH OF _ _ _ _ _ _

20~--

1.

GROSS SALES OF TANGIBLE PERSONAL PROPERTY, LEASES, RENTALS AND SERVICES REPORTED TO STATE OF LA.

ALLOWABLE DEDUCTIONS

2.

SALES FOR RESALE

3.

CASH DISCOUNTS, SALES RETURNS AND ALLOWANCES

4.

SALES DELIVERED OR SHIPPED OUTSIDE THIS JURISDICTION

This return DUE on the

5.

SALES OF GASOLINE AND MOTOR FUELS

1st

day

of

month

6.

SALES TO U.S. GOVT., STATE OF LA., AND ITS POLITICAL SUBDIVISIONS AND AGENCIES

following period covered

by

the

return

and

7.

SALES OF FOOD PAID FOR WITH USDA FOOD STAMPS OR WIC VOUCHERS

becomes DELINQUENT

OTHER DEDUCTIONS AUTHORIZED BY LAW (explain brieflv\

on 21st day.

8.

9.

10.

11. TOTAL ALLOWABLE DEDUCTIONS (Line 2 thru 10)

I

COMPUTATION OF SALES AND USE TAX

12. ADJUSTED GROSS SALES (Line 1 minus line 11 \

13.

14. PURCHASES SUBJECT TO USE TAX IN TERREBONNE PARISH

15. TOTAL rune12 Plus line 14\

16. TAX f5% line 15)

17. EXCESS TAX COLLECTED

18. TOTAL (Line 16 plus line 17)

19. VENDOR'S COMPENSATION (2% of line 18 - deductible onlv when oavment is not delinauent\

20. NET TAX DUE /Line 18 minus line 19\

21. DELINQUENT PENALTY 15% of tax on the date the return becomes delinauent, with an additional 5% for each subseauent 30-dav oeriod, not to exceed 25% in the aaareaate.\

22. INTEREST 1.0329% oer dav from the first dav of the month followina oeriod covered bv the return until oaid. l

23. TOTAL TAX. PENALTY AND INTEREST DUE

24. TAX DEBIT OR CREDIT I authorized memo must be attached)

25. TOTAL AMOUNT DUE (Line 23 olus or minus line 241

26.

27. STATE TAX IDENTIFICATION NUMBER

COMPLETE ONLY IF CHANGE IN BUSINESS STATUS - PLEASE PRINT OR TYPE

DATE BUSINESS DISCONTINUED

NAME OF PURCHASER

CHANGE IN NAME OF BUSINESS

DATE BUSINESS SOLD

MAILING ADDRESS

BUSINESS LOCATION CHANGE

I declare under the penalties for filing false reports that this return (including any accompanying schedule 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, the person's declaration is based on all the information relating to the matters

required to be reported in the return of which the person has any knowledge.

TO AVOID PENALTIES RETURN SHOULD BE TRANSMITTED ON OR BEFORE THE 20th DAY FOLLOWING THE PERIOD COVERED.

DATE

SIGN HERE

BEFORE MAILING PLEASE CHECK ITEMS BELOW

1. Make all remittances payable to PARISH SALES TAX FUND.

2. MAKE SURE return and check are dated and signed.

3. Mall to SALES AND USE TAX DEPARTMENT, P.O. BOX 670, HOUMA, LA 70361-0670.

4. DO NOT use any other taxpayer's return as this will result in improper credit.

SIGNATURE OF PREPARER OTHER THAN TAXPAYER

REVIEWED BY

Phone (985) 876-3734

Fax (985) 876-9841

ACT 738 (1985)