REMIT ALL PAYMENTS TO:
PLEASE INDICATE ANY CHANGES BELOW
Beauregard Parish Sheriff Office (B.P.S.O.)
Sales Tax Department Date out of Business Date Business Sold
P.O. Box 639
DeRidder, LA 70634-0639 Name of New Owner
(337) 462-3451
Fax (337) 463-9952 Mailing Address Change
SALES AND USE TAX REPORT Location Address Change
(Do NOT use any other taxpayer’s return as this may
result in improper credit.)
1. GROSS SALES OF TANGIBLE PERSONAL PROPERTY, LEASES, RENTALS, AND SERVICES
SCHEDULE “A” ALLOWABLE DEDUCTIONS
2. SALES FOR RESALE OR FURTHER PROCESSING (RESALE CERTIFICATE ON FILE)
3. CASH DISCOUNTS, SALES RETURNS AND ALLOWANCES To avoid penalties your envelope
must have an official postmark date
4. SALES DELIVERED OR SHIPPED OUTSIDE THIS JURISDICTION (DOES NOT APPLY TO REPAIRS) on or before the 20 thfollowing the
5. SALES OF GASOLINE AND MOTOR FUELS period covered by the return.
6. SALES TO US GOV’T, STATE OR LA, POLITICAL SUBDV, & LOCAL AGENCIES
7. OTHER SALES OF FOOD PAID WITH USDA FOOD STAMPS OR WIC VOUCHERS
OTHER DEDUCTIONS AUTHORIZED BY LAW (EXPLAIN BRIEFLY) Make a copy for your records
8.
9.
10.
11. TOTAL ALLOWABLE DEDUCTIONS (LINE 2 THRU 10)
12.ADJUSTED GROSS SALES (LINE 1 MINUS LINE 11)
COMPUTATION OF SALES AND USE TAX COMPLETE COLUMNS IN WHICH TAXABLE ACTIVITY OCCURS
A-DeRidder & School Board – Inside City Limits A B C D
B-Police Jury & School Board – DERIDDER 2.25% POLICEJURY 2.25% MERRYVILLE 3.25% DERIDDER 2.25%
Outside all Corporate Limits SCHOOL BOARD 2.00% SCHOOL BOARD 2.00% SCHOOL BOARD 1.00%
BPSO 0.50% BPSO 0.50% BPSO 0.50% Vernon Parish taxes
C-Merryville & School Board – POLICE JURY 0.25% TOTAL 4.75% POLICE JURY 0.25% filed and paid
Parish Wide Inside Town Limits TOTAL 5.00% TOTAL 5.00% separately.
D- Deridder within Vernon Parish
13. ADJUSTED GROSS SALES IN EACH JURISDICTION
14. PURCHASES SUBJECT TO USE TAX IN EACH JURISDICTION
15. TOTAL TAXABLE TRANSACTIONS (LINE 13 PLUS LINE 14)
16. TAX DUE (MULTIPLY LINE 15 BY THE TAX RATE OF EACH COLUMN)
17. EXCESS TAX COLLECTED
18. TOTAL TAX DUE (LINE 16 PLUS LINE 17)
19. VENDORS COMPENSATION (1.50% LINE 18 ONLY PAYMENT IS NOT DELINQUENT)
20. NET TAX DUE (LINE 18 MINUS LINE 19)
21. PENALTY (5% OF TAX FOR EACH 30 DAYS OR FRACTION THERE OF 25% MAX)
22. INTEREST (1.00% PER MONTH CALCULATED FROM DUE DATE UNTIL PAID)
23. TOTAL TAX, PENALTY, AND INTEREST DUE (SUM OF LINES 20 – 22)
24. TAX DEBIT OR CREDIT (AUTHORIZED MEMO MUST BE ATTACHED)
25. TOTAL AMOUNT DUE (LINE 23 PLUS OR MINUS LINE 24)
26. TOTAL REMITTED (TOTAL OF LINE 25 COLUMNS A, B, C) HAVE YOU USED THE PROPER COLUMN?
I declare under the penalties for filing false reports that this return (including any accompanying schedules) has been examined by me and to the best of my knowledge and belief is
a true, correct, and complete return. If the return is prepared by a person other than this taxpayer, his declaration is based on all the information relating to the matters required to
be reported in the return of which he has any knowledge.
This return is DUE on the 1 stday of the month following the period covered by this return and becomes DELIQUENT if not received by this office prior to the 21 stday.
DATE PREPARED SIGNATURE OF INDIVIDUAL OR AGENT & PHONE NUMBER SIGNATURE OF PREPARER & PHONE NUMBER CHECK NUMBER
PHONE NUMBER FOR CONTACT PERSON REVIEWED BY
$20.00 CHARGE ON ALL RETURNED CHECKS
Name: Account #:
Address: Period Covered:
File and pay online at: www.SalesTaxOnline.com OR
www.ParishE-File.com