Form R-6906a - Corporation Franchise Tax Initial Return - 2017
ADVERTISEMENT
1R-6906A (1/17)
Louisiana Department of Revenue
Corporation Franchise Tax Initial Return
PO Box 91011
Baton Rouge, LA 70821-9011
To avoid a penalty, this return must be filed with the Department of Revenue, P.O. Box 91011, Baton Rouge, LA 70821-9011, on or before
the 15
th
day of the third month following the month in which the tax accrues. If the due date falls on a holiday or weekend, the return must
be transmitted on or before the next business day in order to avoid penalty and interest.
For Office Use Only
Louisiana Revenue Account Number
Legal Name
Mailing Address
City
State
ZIP
1a. Period covered:
1b. Fiscal month
__________________________________ through ________________________________
2. FEI number
3. Incorporated in state of:
4. Name and address of former owner (If this entity is successor to an existing business)
5. Name and address of parent company, if applicable
6a. Principal place of business
6b. Telephone number
(
)
7a. Principal Louisiana office location (street address, city, state, zip code)
7b. Telephone number
(
)
8a. Date Louisiana charter issued (mm/dd/yyyy)
8b. Louisiana charter number (issued by Louisiana Secretary of State)
9a. Date business began in Louisiana (mm/dd/yyyy)
9b. Nature of business operation
10. Parishes in which property is located
11. Name and address of registered agent
$ 110.00
Initial Franchise Tax
12.
$
Penalty
13.
(See instructions)
$
Interest
14.
(See instructions)
DO NOT SEND
$
Total Amount Due
Make payment to: Louisiana Department of Revenue
15.
CASH.
Signature of verification
I declare under the penalties for filing false returns that this return has been examined by me, and is, to the best of my knowledge and belief, true, correct,
and complete. Declaration of preparer (other than taxpayer) is based on all information of which he has any knowledge.
Signature of officer
Title
Date (mm/dd/yyyy)
Telephone
(
)
Individual or firm signature of preparer
Date (mm/dd/yyyy)
Telephone
(
)
2340
SPEC
CODE
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial