Form R-20127 - Claim For Refund Of Overpayment Page 2
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1
2INSTRUCTIONS
Claim for Refund of Overpayment (R-20127)
General Information
The Louisiana Department of Revenue has limited authority to issue refunds of overpayments. The Department can only refund an
overpayment if there is express statutory authority to issue the refund.
If your refund request is a medical device refund request, a natural disaster refund request or a pollution control device refund, please
contact the Department for a special refund request packet.
This form should be used to file refund claims for Excise tax, Motor Fuels tax, Sales/Use tax, Severance tax, Withholding tax and certain
other taxes designated by the Office Audit Division. Do not use this form as a substitute for the filing of an amended return or to correct
an error on a previously filed tax return.
Amended sales/use tax returns should be filed for the following reasons:
1.
Gross sales of tangible personal property reported on Line 1 are greater or less than reported on the original return.
2.
Cost of tangible personal property reported on Line 2 is greater or less than reported on the original return.
3.
Leases, rentals, or services reported on Line 3 are greater or less than reported on the original return.
4.
Total allowable deductions as reported on Line 5 (Schedule A) are greater or less than reported on the original return.
5.
Excess tax collected on Line 8 is greater or less than reported on the original return.
6.
If for any reason, the amounts reported on an original sales and use tax return change, an amended return must be filed.
Specific Instructions
1.
Check the appropriate tax box.
2.
Fill in the tax periods included in the refund claim.
3.
Taxpayer’s Legal name. If the taxpayer is a corporation, enter the legal corporation name.
4.
Louisiana revenue account number – self-explanatory.
5.
Taxpayer’s trade name.
6.
Business street address – self-explanatory
7.
City, State, Zip Code – self-explanatory.
8.
Telephone – telephone contact number of claimant and/or claimant’s representative.
Name of claimant or business hired to submit claim information. Please submit a power of attorney form with the refund claim.
9.
10. Contact email address - self-explanatory.
11. Box 1 – total tax paid on the original return for the periods listed on the claim form.
12. Box 2 – total tax actually due for the periods listed on the claim form.
13. Box 3 – requested refund amount
14. Box 4 – subtract vendor’s compensation received on original return. This box applies only if the original sales/use tax return was
filed and paid timely.
15. Box 5 - Net Tax Refund Request – self-explanatory.
16. State reasons for refund request.
Additional schedules documenting the claim for refund amount may be attached. Additional schedules may also be submitted electronically.
Please sign and date your refund request.
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