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                                                                 Bossier City - Parish
                       PO Box 71313  •  Bossier City, LA 71171-1313  • Phone (318) 741-8549 • Fax (318) 741-8997
                                                        Tax RR   eg  istration Application 
NOTE: A separate application is required for each location                                       Please see instructions on reverse side before completing this form
                       Check all that apply:              Sales Tax                        Hotel/Motel             Occupational License                    Chain Store      
1.   Reason for applying
       A. Started new business                                                                           C. Opening additional location
       B. Purchased ongoing business:                                                                    D. Merger  
           1. Name of previous owner
           2.Trade name of previous owner                                                                E. Change of Name 
            3. Previous Owner Bossier Parish account number                                              F. Other
2.     A. LA Sales and Use Tax Number                                                            n                             Applied For                        None
       B. Federal Identification Number                                       n                                                Applied For                        None
        C. Federal Standard Industrial Code                                                                      
        D. How many other business locations in this Parish
3.    A. Legal name - Individual, Partners, or Corporation
   B. Trade name of business
4.     Business location address                                                                                     City and State
                                                          (Streetaddress- Donot enterPO Box)
      Zip code                                     Telephone (           )                                            Parish in LA
5.     Mailing Address for receiving tax forms and correspondence
                                                                                                                               (If same as location, write "Same")
    City and State                                                                                                   Zip code

6.     Contact Person                                                                                   Contact Phone number (         ) 
       Fax number                                       E-mail Address                                                Website Address
    Location of accounting records
7.   Type of organization                        Individual              Partnership                  Corporation                 LLC                                                                                    LLP
            Governmental                         Non-profit             Other (Specify)
8.    If sole owner- List Individual Name                                                                                         SSN
     Home address                                                                                                  Telephone  (          ) 
9.    If Corporation, LLC, LLP, or Partnership: List Name, Title, Social Security Number, Home address, and Telephone number
        of officers, members, managers, or partners (Attach continuation sheet if needed)

           Name                                                                            Title                                   SSN

           Address                                                         City State Zip                                          Phone Number
           Name                                                                            Title                                   SSN
           Address                                                         City State Zip                                          Phone Number
10.   Agent for service of process
                                                       Name                                                                              Physical address                                                          Telephone number
11.  First date sales will be made from this location                                                Date business first started operations
12.  A. Nature of business:      Retail Sales                            Repair Service          Retail Service                Wholesale   Contractor
                                                 Manufacturing/Fabricating                       Other
     B.  Describe in detail your business
                                                                                           Type of sales, activity, or service 
13.  Requested Reporting Status:                          Monthly                    Quarterly                       Occasional/Irregular
       Reporting frequency - All new accounts are required to file parish sales/use tax returns on a regular monthly basis unless sales tax receipts average less than   
       $  500.00 per month. Occasional/irregular filers are for businesses (1) that do not transact business within BossierCity/Parish on a regular basis, or (2) that perform  
       services that are exempt from taxation.

14.  Have you registered with the Louisiana Secretary of State as a foreign corporation?                                                  Yes                          No                                                           No

I affirm that the information given on this application is true and correct.                   15.    For Office Use Only 

                                                                                                                                                                                                                       n
Signature of Applicant                                                  Title
                                                                                                                License Number                                       
Signature of Preparer (if different from above)                          Date                                                      n                                                                                               n
Visit us at www.bossiercity.org                                  Visit us at www.laota.com      Sales Tax Account Number            Own/Loc/Mail           Group  



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8/2001                       Instructions for Tax Registration Application for Bossier City - Parish

Please review these instructions carefully. Failure to complete ALL applicable lines     1.  Reason for applying.
will delay the processing of this application, the assigning of your tax number, and
the issuance of the applicable certificate. Please type or use only a black or blue ink       A. Self-explanatory.
pen to fill out this form.                                                                    B. If buying an existing business, have you received verification from
                                                                                                 the  taxing authority that  all tax liabilities  have been paid?
                                                                                                 (LA R.S. 47:308 - see below).
Who must file  - Each person pursuing any trade, profession, vocation, calling or             C. Self-explanatory.
business should complete this form.  Each person is required to keep reasonable               D. List all the business names that created the merger.
records. Separate records are required for each place of business. For assistance call        E. Self-explanatory
(318) 741-8551.                                                                               F. Indicate if this is a change in business structure or if acquired by
                                                                                                 gift, trust, etc.
Sales and use tax - Any individual, firm, corporation, trust, co-partnership, joint      2.   A. Self-explanatory. (If you have none, mark the box.)
venture, association,  or LLC/LLP is required to file and remit the appropriate               B. Self-explanatory. (If you have none, mark the box.)
sales taxes  by  the twentieth (20th) day following the close of each reporting               C. Self-explanatory.
period for  any  of  the following transactions  listed below  that are taxable under         D. List  the  number of  business  locations  in Bossier City/Parish.
the Sales and UseTax Statutes and Ordinances:                                                    Each location requires a separate application and account number.
                                                                                         3.   A. Legal Name - The person(s) or corporation under whose name this
1.  The sale of tangible personal property at retail in this parish;                             business is to be registered. If corporate, give true corporate name.
2.  The use, consumption, distribution, or storage for use or consumption, in this            B. Trade Name - The name under which this business will operate - the
    parish of any tangible personal property;                                                    dba name. If you have no trade name, leave this line blank.
3.  The lease or rental within this parish of any item or article of tangible personal
    property;                                                                            4.      Location Address - This  address is the  street address or other
4.  The sale of services  as  defined in  the  statutes. These  services include  the            meaningful address, the city, town, or village, and the ZIP Code, in
    furnishing of rooms by hotels; the sale of admissions to places of amusement                 which your business is geographically located, irrespective of where
    and to athletic and recreational events, and the furnishing of  the privilege of             you receive your mail.
    access  to amusement, entertainment,  athletic,  or  recreational facilities;  the           Telephone number at the business location.
    furnishing of storage or parking privileges by auto hotels and parking lots; the             If business is located in LA, list the parish where it is located.
    furnishing  of  printing  or  overprinting; the  furnishing  of  laundry  cleaning,
    pressing,  and dyeing services;  the furnishing  of cold storage  space and  the     5.      Mailing Address - ALL tax returns, licenses, and other related
    preparation  of property  for such storage;  and, the  furnishing  of repairs  to            communications will be mailed to this address.
    tangible personal property.
                                                                                         6.      The name of the person responsible for the sales tax return.
Any  person  who  leases  or rents  tangible  personal  property  in the  parish, who            Telephone number of the person responsible for the sales tax return.
furnishes services taxable under the statue s and ordinance s,who holds property in the          The fax number at the mailing address.
parish for resale, who maintains a business location in the parish, or who solicits              The e-mail address of the person responsible for the sales tax return.
orders, or otherwise operates in the parish through full-time or part-time resident or           The web address of the company.
nonresident salesmen or agents, is required to obtain a sales tax certificate, collect           Where the accounting records are kept.
the proper taxes from customers, and file returns with the     Bossier City - Parish
Sales and Use Tax Division. For local sales tax purposes, only retail transactions       7.      Type of organization, mark only one.
are taxable. Therefore, a resale certificate should be used on wholesale purchases.              Self-explanatory.
                                                                                                 Self-explanatory.
A person who purchases, imports, or receives property and services subject to tax,               Self-explanatory.
or is the lessee or rentee of tangible personal property on which the proper taxes               Self-explanatory.
were not collected by vendors, is himself liable for the payment of taxes directly to            Self-explanatory.
the Bossier City - Parish  Sales and Use Tax  Division       .                                   Government - i    ndicate on line provided if parish, school district, 
                                                                                                 or related entity such as hospital or library.
                                                                                                 Non-profit -generally  must  conform to Federal IRS  regulations for
                                                                                                 determining a nonprofit organization. Indicate on line provided if
                                                                                                 organized for  religious, scientific, humane,  fraternal, or  other
                                                                                                 purpose.
                                                                                                 Other - If applicable mark this box & explain.
                                                                                         8.      Self-explanatory.
                                                                                         9.      Self-explanatory.
                                                                                         10.     The person responsible for accepting notices on behalf of the legal
                                                                                                 entity that apply to due process requirements.
                                                                                         11.     Indicate date that first sales will be made from this location.
                                                                                                 Indicate date the business started.
                                                                                         12.  A. Choose one.
                                                                                              B. Describe the kind of business to be carried on at this location.
                                                                                         13.     Check the filing frequency you are requesting.
                                                                                         14.     Self-explanatory.

Note:  You  must sign and  date your application.  If your application was prepared  by someone  else, they  must  also sign  in the  appropriate space. Mail  the
application to PO Box 71313 •  Bossier City, LA 71171-1313  • (318) 741-8549 or visit us at www.bossiercity.org

LA R.S 47:308. Termination or transfer of business                                       stating that no taxes, interest, or penalties are due. If the purchaser of a business
                                                                                         or stock of goods fails to withhold purchase money as above provided, he shall
                                                                                         be personally liable for the payment of the taxes, interest, and penalties accrued
A. If any dealer liable for any tax, interest, or penalty levied hereunder sells his     and unpaid on account of the operation of the business by any former owner,
business or stock of goods or quits the business; he shall make a final return and       owners, or assigns.
payment within fifteen days after the date of selling or quitting the business. His
successor,  successors,  or assigns,  if any, shall   withhold  sufficient of  the       B. In the case of a dealer who has quit a business, and who subsequently opens
purchase money to cover the amount of such taxes, interest, and penalties due            another similar business under the same ownership, whether that ownership is
and unpaid until such  time as the former owner shall  produce a                         individual, partnership, corporation, or other, that dealer shall be liable for any
receipt  from  the  secretary  showing  that  they  have  been  paid, or a certificate   tax ,interest, or penalty owned by the original business.






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