Form R-6922 - Louisiana Composite Partnership Return
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1
2
3R-6922 (1/12)
Extension
If your name has
If amended return,
If final return,
O
O
O
O
attached
changed, mark circle.
mark circle.
mark circle.
You must enter your Louisiana Revenue
Louisiana Composite
Account Number here
Partnership Return
Louisiana Department of Revenue
P. O. Box 201
PLEASE PRINT OR TYPE.
Baton Rouge, LA 70821-0201
Partnership Name
Address
Fie ld fla g
FOR OFFICE USE ONLY.
City
State
ZIP
Income Taxable Period
Calender/Fiscal year ending
Summary of tax paid on behalf of partners
Total distributive income for RESIDENT partners included with the Louisiana Composite Partnership
.00
1
Return (Total from Line A of Resident Partners Schedule)
Total amount of income tax paid on behalf of qualified Resident partners with this Composite
.00
2
Partnership filing. (Total from Line C of Resident Partners Schedule)
Total distributive income for NONRESIDENT partners included with the Louisiana Composite
.00
3
Partnership Return (Total from Line A of Nonresident Partners Schedule)
Total amount of income tax paid on behalf of qualified NONRESIDENT partners with this Composite
.
4
00
Partnership filing. (Total from Line C of Nonresident Partners Schedule)
Computation of amount due
.00
5 Total tax (Add Lines 2 and 4 and print the result.)
Amount paid on your behalf by a composite partnership filing
.00
6
Print the name of the partnership.
____________________________________________________________________
.00
7 Estimated payments for 2011.
.00
8 Amount paid with extension request - See instructions.
.
9 Total payments (Add Lines 6, 7, and 8 and print the result.)
00
.
10 Overpayment - If Line 9 is greater than Line 5, subtract Line 5 from Line 9 and print the result.
00
.
00
11 Amount You Owe - If Line 5 is greater than Line 9, subtract Line 9 from Line 5 and print the result.
.
12 Interest - See instructions.
00
.
13 Delinquent Filing Penalty
00
.
00
14 Balance Due Louisiana - Add Lines 11, 12, and 13 above and print the result.)
Make payment to Louisiana Department of Revenue.
Do not send cash.
Under 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. Declaration of paid preparer is based on all available information.
Signature
Date (dd/mm/yyyy)
Signature of paid preparer other than taxpayer
Social Security Number, PTIN, or FEIN of paid preparer
2750
SPEC
CODE
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