CLAIBORNE PARISH SALES AND USE TAX REPORT
Make all remittances payable to:
CLAIBORNE PARISH SCHOOL BOARD
SALES TAX DEPT.
P. 0. BOX 600, HOMER, LOUISIANA 71040 File Online At:
PHONE 318-927-3502 ParishE-File.revenue.louisiana.gov
For more information, visit
Account:_______________ Frequency:______________
www.lataonline.org
Period Covered: ____________________________________
Name: ____________________________________________
Address:___________________________________________
__________________________________________________
(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 AS REPORTED TO STATE OF LOUISIANA
SCHEDULE “A” ALLOWABLE DEDUCTIONS
2. SALES FOR RESALE OR FURTHER PROCESSING (RESALE CERTIFICATE ON FILE)
3. CASH DISCOUNTS, SALES RETURNS AND ALLOWANCES
4. SALES DELIVERED/SHIPPED OUTSIDE JURISDICTION (DOES NOT APPLY TO REPAIRS)
5. SALES OF GASOLINE AND MOTOR FUELS
6. SALES TO US GOVT, STATE OF LA, POLITICAL SUBDIVISIONS AND LOCAL AGENCIES
7. SALES OF FOOD PAID WITH USDA FOOD STAMPS OR WIC VOUCHERS
OTHER DEDUCTIONS AUTHORIZED BY LAW (EXPLAIN)
8.
9.
10.
11. TOTAL ALLOWABLE DEDUCTIONS (Lines 2 through 10)
12. ADJUSTED GROSS SALES (Line 1 minus Line 11)
A – 3.625% B-6.00% C-5.125% D-4.625% E-4.625%
RURAL HOMER HAYNESVILLE JUNCTION CITY ATHENS
IMPORTANT: COMPUTATION OF SALES AND USE TAX SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD
PJ WS WS HPD REC. WS PJ WS PJ WS
HOSPITAL HOSPITAL HOSPITAL HOSPITAL HOSPITAL
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 COMPENSATON (2% LINE 18) ( ONLY IF PAYMENT IS NOT DELINQUENT)
20. NET TAX DUE (LINE 18 MINUS LINE 19)
21. PENALTY (5% of Tax for each 30 Days or Fraction Thereof, 25%Max )
22. INTEREST (1% PER MONTH CALCULATED FROM DATE DUE UNTIL PAID)
23. TOTAL TAX, PENALTY, AND INTEREST DUE (SUM OF LINE 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,D,E)
I declare under the penalties for filing false reports that this return (including any accompanying schedules and statements) 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 1st day of the month following the period covered by this return and becomes DELINQUENT not postmarked by the 20th of the month the tax was due,
DATE PREPARED SIGNATURE OF INDIVIDUAL OR AGENT & PHONE NUMBER SIGNATURE OF PREPARER & PHONE NUMBER State ID #
Phone Number for Contact Person Reviewed By
PJ = POLICY JURY WS = WATER SHED PLEASE INDICATE ANY CHANGES BELOW