SALES AND USE TAX City of Baton Rouge - Parish of East Baton Rouge LOCAL RATE A - 5.5% B - 5.5% C - 5.5% D - 6% E - 6% F - 5.5% G - 6% H - 6%
REPORT Dept of Finance-Revenue Division
PO Box 2590 1701 - CITY OF BATON 1700 - PARISH OF EBR 1706 - PARISH OF EBR 1702 - CITY OF BAKER 1707 - CITY OF BAKER 1705 - CITY OF 1703 - CITY OF 1708 - PARISH OF EBR
ROUGE / EBR PARISH / EBR PARISH SCHOOL / ZACHARY SCHOOL / BAKER SCHOOL / EBR PARISH SCHOOL ZACHARY / ZACHARY CENTRAL / CENTRAL / CENTRAL SCHOOL
Baton Rouge, LA 70821-2590 SCHOOL DISTRICT DISTRICT DISTRICT DISTRICT DISTRICT SCHOOL DISTRICT SCHOOL DISTRICT DISTRICT
Phone: (225) 389-3084 Fax: (225) 389-5369
www.brla.gov/659/Taxes 13. ADJUSTED GROSS SALES IN EACH JURISDICTION
(Totals of columns must equal LINE 12)
BUSINESS NAME 14. PURCHASES SUBJECT TO USE TAX IN EACH JURISDICTION
EBR PARISH ACCOUNT 15. TOTAL (Line 13 plus Line 14)
NUMBER 16. TAX - ( ___ % Line 15) (Multiply Line 15 by percent shown at top of column)
PERIOD COVERED , 20 16a. Reduced Rate Deductions per Schedule A
Make Remittance Payable to PARISH AND CITY TREASURER 16b. Net Tax Due (Line 16 minus Line 16a)
This return is DUE on the 1st 17. EXCESS TAX COLLECTED
CHECK #
day of the month following 18. TOTAL (Line 16b plus Line 17)
the period covered by this
return and becomes
TOTAL REMITTED DELINQUENT if not 19. Vendor's Compensation
postmarked prior to the 21st (1% of Line 18 deductible only when payment is not delinquent)
$15.00 NSF CHARGE ON ALL NSF CHECKS day. 20. NET TAX DUE (Line 18 minus Line 19)
ROUND ALL NUMBERS AND YOUR CHECK TO THE NEAREST DOLLAR 21. DELINQUENT PENALTY (5% of tax for each 30 days or fraction thereof of
delinquency, not to exceed 25% in the aggregate)
1. Gross Sales of Tangible Personal Property, Leases, Rentals & 22. INTEREST (1% per month or fractional part thereof from date due until
Services Reported to the State of Louisiana paid)
ALLOWABLE DEDUCTIONS 23. TOTAL TAX, PENALTY and INTEREST DUE
2. Sale for Resale 24. TOTAL DEBIT OR CREDIT (Authorized memo must be attached)
3. Cash Discounts, Sales Returns & Allowances 25. TOTAL AMOUNT DUE (Line 23 plus or minus Line 24)
4. Sales Delivered Outside of East Baton Rouge Parish LOCAL RATE K - 6.5% L - 7.5% M - 7.5%
5. Sales of Gasoline and Motor Fuels 1709 - AMERICANA 1710 - HARVESTON 1711 - THIRD-
6. Sales to the U.S. Government and State of Louisiana EDD EDD FLORIDA EDD
7. Sales of food paid with (USDA) stamps or WIC vouchers ADJUSTED GROSS SALES IN EACH JURISDICTION
Other Deductions (Provide Brief Explanation) 13. (Totals of columns must equal LINE 12)
8. 14. PURCHASES SUBJECT TO USE TAX IN EACH JURISDICTION
9. 15. TOTAL (Line 13 plus Line 14)
10. 16. TAX - ( ___ % Line 15) (Multiply Line 15 by percent shown at top of column)
11. Total allowable deductions (Lines 2 thru 10) 16a. Reduced Rate Deductions per Schedule A
12. Adjusted gross sales (Line 1 minus 11) 16b. Net Tax Due (Line 16 minus Line 16a)
17. EXCESS TAX COLLECTED
18. TOTAL (Line 16b plus Line 17)
*99999999*
Date Business Discontinued 19. Vendor's Compensation
Date Business Sold (1% of Line 18 deductible only when payment is not delinquent)
20. NET TAX DUE (Line 18 minus Line 19)
Business Name Change Name & Address of Purchaser 21. DELINQUENT PENALTY (5% of tax for each 30 days or fraction thereof of
delinquency, not to exceed 25% in the aggregate)
22. INTEREST (1% per month or fractional part thereof from date due until
paid)
Business Location Change Mailing Address Change 23. TOTAL TAX, PENALTY and INTEREST DUE
24. TOTAL DEBIT OR CREDIT (Authorized memo must be attached)
25. TOTAL AMOUNT DUE (Line 23 plus or minus Line 24)
I declare under the penalties for filing fake reports that this return (including accompanying schedules OFFICE USE ONLY: Transaction
and statements) has been examined by me and to the best of my knowledge and belief is true and AUTHORIZED SIGNATURE TITLE DATE Postmark Date Type
correct and complete. If the return is prepared by a person other than the taxpayer, his declaration is
based on all the information relating to the matters required to be reported on the return of which he
has any knowledge.