PARISH OF ACADIA
SALES AND USE TAX DEPARTMENT
P.O. DRAWER 309
CROWLEY, LA 70527-0309 Report Month:
Address Correction Requested ------------
Phone: 337-783-3664
Fax: 337-783-9428 Check Number:
1 _ GROSS SAL S OF TANGIBLE PERSONAL PROPERTY, LEASES, RENTALS E
AND SERVIC S AS REPORT D TO TH STATE OF LOUISIANA E E E 1. SALES AND USE TAX REPORT )
(
ALLOWABLE DEDUCTIONS
This return is due on the 1st day of the month following the period
2. SALES FOR RESALE OR FURTHER PROCESSING (CERTIFICATE ON FILE) COMMENTS covered by this return and becomes DELINQUENT on the 21st day. To
3. CASH DISCOUNTS, SALES RETURNS ANO ALLOWANCES avoid penalties, your envelope must have an official postmark dated on or
before the 20th following the period covered by the return.
4. SALES DELIVERED OR SHIPPED OUTSID ACADIA PARISH E
5. SALES OF GASOLINE AND MOTOR FUELS P L EASE INDICATE ANY CHANGES BELOW:
6, SALES TO THE US GOV'T . THE STATE OF LA ITS POLITICAL SUBDIVISIONS AND AGENCIES
E DATE BUSINESS SOLD NAME AND ADDRESS OF PURCHASER
7. SALES OF FOOD PAID FOR WITH USDA FOOD STAMPS OR WIC VOUCH RS
OTHER D DUCTIONS AUTHORIZED BY LAW (EXPLAIN BRIEFLY) E
DATE BUSINESS DISCONTINUED BUSINESS LOCATION CHANGE
8.
10.
CONSOLIDATED SALES & USE TAX REPORT FOR ACADIA PARISH
11 . TOTAL ALLOWABLE DEDUCTIONS (LINE 2 THROUGH LINE 10) -11. COMPLETE ONLY COLUMNS IN WHICH TAXABLE ACTIVIT Y OCCURS
12. ADJUSTED GROSS SALES (LINE 1 MINUS LINE 11) 12.
TOTAL LOCAL RATE -----I A. 5.5% B. 5.25% C. 5.25% D. 4.25% E. 4.25% F. 5.00% G. 4.25% H. 3.25% I. 4.25%
CROWLEY CHURCH POINT IOTA ESTHERWOOD MERMENTAU RAYNE MORSE EUNICE UNINCORPORATED
COMPUTATION OF SALES SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD BASILE SCHOOL BOARD
& USE TAX POLICE JURY & POLICE JURY & POLICE JURY & POLICE JURY & POLICE JURY & POLICE JURY & POLICE JURY & DUSON POLICE JURY &
D E ES SHERIFF'S DEPT SHERIFF'S DEPT SHERIFF'S DEPT SHERIFF'S DEPT SHERIFF'S DEPT SHERIFF'S DEPT SHERIFF'S DEPT SHERIFF'S DEPT
13. � §��i Ju�1iirtrrt� 13.
14. PURCHASES SUBJECT TO USE TAX IN EACH JURISDICTTON 14.
15. TOTAL (LINE 13 PLUS LINE 14) 15.
16. TAX DUE ·::c-c::_,_ . _,, .. ,_,_., __ ,_._ 16.
17. EXCESS TAX COLLECTED 17.
18. TOTAL (LINE 16 PLUS LINE 17) 18.
1 9. ifN��;/;f1PENSA1lON PAYf.-iENT NOT DELINQUENT DEDUCTIBLE ONLY WHEN 19.
20. NET TAX DUE (LINE 18 MINUS LIN 19) rnr 00 f E 20.
=j!;
f�:
22. INT R STE E 1 pe month or fr�;� ��:r;;
21 . Dei� ;n�; ��; � % r :��c���\�::���r:;:�;: 21. nd 1 22.
23. TOTAL TAX, P NALTY AND INTEREST DUEE O E 23.
24. TAX DEBIT OR CREDIT ���� BR��8A�i�i 24.
25. TOTAL AMOUNT DUE (UNE23PLUSORMINUSLINE24) 25.
26 . REMITTANCE ATTACHED (Totals MAKE Y O UR REMITTANCE ACADIA PARISH SCHOOL BOARC L in e I TOTAL R MITTED E
of cols.: A,B,C,D,E,F,G,H & I) I PAYABLE TO: SALES & USE TAX DEPARTMENT ifohii·ii.i i·iiiiii·MU·M: · 26 iBs�
::
examined\ declare underby metheandpenaltiesto the bestfor filingof myfalseknowledgereportsandthatbeliefthis returnis true,(includingcorrect,anyandaccompcomplete.anyingIf theschedulesreturn is prep andaredstatements)by a personhas beenother jLA TAX IDENTIFICATION NO.H I BUSINESS LO CATI ON
than the taxpayer, his declaration is based on all the information relating to the matters required to be reported in the re turn of which he has
any knowledge. "Returns by taxpayer previously registered by Acad ia Parish, shall extend registration to all t a xing jurisdictions."
$20.00 CHARGE ON DAT E I AUTHORIZ D SIGNATUR (MANDATORY) E E PHON NUMBER E REVI W D BY E E
ALL "NSF" CHECKS (