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            IBERIA PARISH SCHOOL BOARD                                                                                                                                                                                                                                                                                                                                                  To file and pay online:
            SALES & USE TAX DEPARTMENT
    P.O. BOX 9770 * NEW IBERIA, LA 70562-9770                                                                                                                                                                                                                                                                                                                                     www.SalesTaxOnline.com
    Phone:  (337) 365-2341  *  Fax: (337) 365-6584                                                                                                                                                                                                                                                                                                                                                                      or
        SALES TAX INFO.: LATAONLINE.ORG                                                                                                                                                                                                                                                                                                                                     parishe-file.revenue.louisiana.gov
    GROSS SALES OF TANGIBLE PERSONAL PROPERTY, LEASES, RENTALS
1.  AND SERVICES AS REPORTED TO THE STATE OF LOUISIANA        1.                         (BEFORE TAXES)      
                                                                                                                                                                                        Account #
                 ALLOWABLE DEDUCTIONS

2. SALES FOR RESALE OR FURTHER PROCESSING (CERTIFICATE ON FILE)                                                                                                                         MONTH: _______________________________
3. CASH DISCOUNTS, SALES RETURNS AND ALLOWANCES
4. SALES DELIVERED OR SHIPPED OUTSIDE THIS JURISDICTION (DOES NOT APPLY TO REPAIRS.)
5. SALES OF GASOLINE AND MOTOR FUELS
6. SALES TO THE US GOVT. , THE STATE OF LA, ITS POLITICAL SUBDIVISIONS AND AGENCIES
7. PURCHASES PAID WITH FOOD STAMPS OR WIC VOUCHERS
Other Deductions Authorized  by Law (Explain Briefly)
8.  
                                                                                                                                                                                                                                                                                                       DO NOT STAPLE OR CLIP CHECK TO FORM
9.                                                                                                                                                                                Date Business Discontinued                                                                                           Date Business Sold                                                                        Name of Puchaser
10.                                                                                                                                                                               Business Location Change                                                                                             Mailing Address Change                                                                    Change in Name of Business
11. TOTAL ALLOWABLE  DEDUCTIONS (LINE 2 THROUGH LINE 10)                     11.
12.  ADJUSTED GROSS SALES (LINE 1 MINUS LINE 11)                                                                                                                                                               COMPLETE ONLY COLUMNS IN WHICH TAXABLE ACTIVITY OCCURS
                                                                                                                                                                                                                                                                                                                                                                            HWY 14-EDD #1
                                                                                                                                                                                  LOREAUVILLE                                                                                                          EDDSCHOOL#1 IBERIABOARDPARISH    NEWSCHOOLIBERIABOARDANNEX           NEW IBERIA                                  HWYNEW182-EDDIBERIA#1         NEWNEWIBERIAIBERIAEDD #3
                                                                          NEW IBERIA     JEANERETTE                                             PARISHSCHOOLDELCAMBREMOSQUITOBOARDPARISHSCHOOLMOSQUITOBOARD                                                                                            PARISHPARISHRECREATIONMOSQUITO   PARISH MOSQUITO                     PARISHSCHOOLMOSQUITOBOARD                  PARISHSCHOOLMOSQUITOBOARD      SCHOOL BOARD
                                                                          PARISH MOSQUITO
                                                                          SHERIFF’S DEPT
                                                                          A. 5.00%       B. 4.50%                                               C. 3.75%                          D. 4.25%                     PARISHUNINCORPORATEDPARISHPARISHSCHOOLSHERIFF’SE.RECREATIONMOSQUITOGARBAGE3.25%BOARDDEPTPARISHSHERIFF’SF.GARBAGE4.25%DEPTPARISHSHERIFF’SG.RECREATION5.25%DEPTPARISHSHERIFF’SK.RECREATION5.75%DEPTPARISH RECREATIONSHERIFF’SL. 5.75%DEPTPARISHSHERIFF’SM.MOSQUITO5.50%DEPT
    COMPUTATION OF SALES AND USESCHOOLTAXBOARD                                           PARISHPARISHSCHOOLSHERIFF’SRECREATIONMOSQUITOBOARDDEPT PARISHSHERIFF’SRECREATIONDEPT     PARISHSHERIFF’SRECREATIONDEPT
    ADJUSTED GROSS SALES               Total of Columns
13. IN EACH JURISDICTION               Must Equal Line 12
14. PURCHASES SUBJECT TO USE TAX 
    IN EACH JURSIDICTION
15. TOTAL(LINE 13 PLUS 14)
16. TAX DUE      MULTIPLY LINE 15 BY
            % SHOWN IN PROPER COLUMN
17. EXCESS TAX COLLECTED
18. TOTAL (LINE 16 PLUS LINE 17)
19. VENDORS  COMPENSATION             DEDUCTIBLE ONLY WHEN
    1% OF LINE 18                     PAYMENT NOT DELINQUENT
20. NET TAX DUE (LINE18 MINUS LINE 19)
21. DELINQUENT     5%OF TAX FOR EACH 30 DAYS OR FRACTION THEREOF,
    PENALTY       Delinquency not to exceed 25% in the aggregate
22. INTEREST - 1.00% PER MONTH (.0003288 PER DAY FROM DUE DATE UNTIL PAID)
23. TOTAL TAX, PENALTY AND INTEREST DUE
24. TAX DEBIT OR CREDIT (AUTHORIZED MEMO MUST BE ATTACHED)
25. TOTAL AMOUNT DUE (LINE 23 PLUS OR MINUS LINE 24)
   This return is DUE on the 1st day of the month following the period covered by this   TOTAL OF COLUMNS A + B + C + D + E + F + G + K + L + M                                                                                                                                                                                                                                   Line 26                              TOTAL REMITTED
   return, and becomes DELINQUENT if not transmitted on or before the 20th day.          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 completed return. If the return is prepared by a person 
                                                                                         he has any knowledge. 
   Remittances Payable to: Iberia Parish Sales & Use Tax Department                      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                                                                                                                                                                              $

Signature of Individual or Agent_________________________________________          Date______________________________    State Tax ID#   ________________________________






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