Form R-20131 - Request For Abatement Of Interest

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R-20131 (1/08)
Request for Abatement of Interest
Louisiana Department of Revenue
P. O. Box 66658
Baton Rouge, LA 70896-6658
PLEASE PRINT OR TYPE.
Taxpayer Name
Louisiana Revenue Account ID Number
Tax Type
Tax Period(s)
Amount of Interest to be Abated
Louisiana Revised Statute 47:1601(A)(2)(c) provides that the secretary may abate all or any part of interest for any period if the assess-
ment of interest is attributable, in whole or in part, to any unreasonable error or delay by the secretary or a designee acting in an official
capacity in the performance of a ministerial or managerial act as defined in Louisiana Administrative Code 61:III.2115.A. The request to
abate the interest will be considered only if no significant part of the error or delay can be attributed to the taxpayer involved.
Request is hereby made for the abatement of interest based on the following reasons:
Under penalty of perjury, I declare all of the facts provided above as a basis for an abatement, to the best of my knowledge and belief,
including all accompanying documentation, are true, correct, and complete.
Taxpayer’s Authorized Representative
Title
Signature of Authorized Representative
Date (mm/dd/yyyy)
FOR OFFICIAL USE ONLY
Amount of Interest Abated
Approved
Disapproved
Department Representative
Approval Date

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