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             JEFFERSON DAVIS PARISH SCHOOL BOARD 
             SALES AND USE TAX DEPARTMENT                                                                                                                                                                                                                                 SALES AND USE TAX REPORT 
                                  P.O. BOX 1161                                                                                                                                                                                                                                                       
                PHONE (337) 824-2744                                                                                                                                                                                                                                      JEFFERSON DAVIS PARISH SCHOOL BOARD - 
                JENNINGS, LA 70546                                                                                                                                                                                                                                        CITY OF JENNINGS - TOWN OF LAKE ARTHUR- TOWN 
                                                                                                                                                                                                                                                                          OF WELSH - TOWN OF ELTON-VILLAGE 
                                                                                                                                                                                                                                                                          OF FENTON- SALES TAX DISTRICT #1 
             MONTH ENDING:                                                                                                                                                                                                Final Return 
                                                                                                                                                                                                                                                                                  ROAD SALES TAX DISTRICT #1 
             ACCOUNT NO.:                                                                                           Filing Frequency 
                                                                                                                                                                                                                                                                          LAW ENFORCEMENT SALES TAX DISTRICT #1 
             ACCOUNT NAME:         
                                   
                                                                                                                                                                                                                                                                          SALES FOR MONTH OF      
 1.  GROSS SALES OF TANGIBLE PERSONAL PROPERTY, LEASES, RENTALS AND 
            SERVICES AS REPORTED TO THE STATE OF LOUISIANA                                                                                                                                                                                                                                
                                     ALLOWABLE DEDUCTIONS                                                                                                                                                                                                                 File online now at 
2.          SALES FOR RESALE OR FURTHER PROCESSING                                                                                                                                                                                                       https://parishe-file.revenue.louisiana.gov 
3.          CASH DISCOUNTS, SALES RETURNS AND ALLOWANCES                                                                                                                                                                        
4.          SALES DELIVERED OUTSIDE OF JEFFERSON DAVIS PARISH                                                                                                                                                                  PLEASE INDICATE ANY CHANGES BELOW: 
5.          SALES OF GASOLINE AND MOTOR FUELS                                                                                                                                                                                   
 6.         SALES TO THE U.S. GOVERNMENT, STATE OF LOUISIANA                                                                                                                                                                    
            AND ITS POLITICAL SUBDIVISIONS AND AGENCIES                                                                                                                                                                        DATE OUT OF BUSINESS                                          DATE BUSINESS SOLD                               
7.          SALES IN INTERSTATE COMMERCE                                                                                                                                                                                        
8.          SALES OF FERTILIZER, FEED & SEED SOLD TO FARMERS                                                                                                                                                                   NAME OF NEW OWNER                                                                                              
                                                                                                                                                                                                                                
9.          PURCHASES PAID WITH FOOD STAMPS OR WIC VOUCHERS                                                                                                                                                                    COMMENTS:___________________________                                                                           
10. ANY OTHER DEDUCTIONS AUTHORIZED BY LAW (EXPLAIN)                                                                                                                                                                            
                                                                                                                                                                                                                                                                                                                                              
11. TOTAL ALLOWABLE DEDUCTIONS (Line 2 thru 10)                                                                                                                                                                                 
12. ADJUSTED GROSS SALES (Line 1 minus line 11)                                                                                                                                                                                                                                                                                               
                COMPUTATION OF SALES AND USE TAX 
            ALL APPLICABLE PARISH LEVIES ARE INCLUDED IN THE RATE                                                                                                                                         A                     B                   C                     D                   E                    F                 G  
            DISPLAYED IN EACH COLUMN                                                                                                                                                                      UNINCORPORATED     CITY OF JENNINGS     TOWN OF LAKE ARTHUR     TOWN OF WELSH      TOWN OF ELTON     VILLAGE OF FENTON     SALES TAX DISTRICT #1  
                                                                                                                                                                                                          5.0%                  5.5%                5.5% 
         (LINE 13 COLUMNS A, B, C, D, E, F, AND G EQUAL LINE 12)                                                                                                                                          AREAS                                                           5.0%               4.0%                  5.0%              5.5% 

13.14.  ADJUSTED GROSS SALES IN EACH JURISDICTION PURCHASE SUBJECT TO USE TAX IN EACH JURISDICTION                                                                                                                                                                                                                                          
15. TOTAL (Line 13 plus line 14)                                                                                                                                                                                                                                                                                                           
17.16.  EXCESS TAX COLLECTED TAX DUE (MULTIPLY LINE 15 BY % SHOWN IN COLUMN)                                                                                                                                                                                                                                                                
18. TOTAL (Line 16 plus line 17)                                                                                                                                                                                                                                                                                                           

21. DELINQUENT PENALTY   
20.19.  VENDOR'S COMPENSATION (2% of line 18 if not delinquent) NET TAX DUE (Line 18 minus line 19) DELINQUENCY NOT TO EXCEED 25% IN THE AGGREGATE.)(5% OF TAX FOR EACH 30 DAYS OR FRACTION THEREOF.                                                                                                                                         
22. INTEREST (1.00% PER MONTH FROM DUE DATE UNTIL PAID)                                                                                                                                                                                                                                                                                    
23. TOTAL TAX, PENALTY AND INTEREST DUE                                                                                                                                                                                                                                                                                                    

26.25.24.   TOTAL REMITTANCE: COLUMNS A, B, C, D, E, F & G (Line 25) $ TOTAL AMOUNT DUE (Line 23 plus or minus line 24) TAX DEBIT OR CREDIT (Authorized memo must be attached)                                                                                                                                                              
 TO AVOID PENALTIES BE SURE THAT YOU                              I DECLARE UNDER THE PENALTIES FOR FILING FALSE REPORTS THAT THIS RETURN (INCLUDING ANY ACCOMPANYING SCHEDULES AND STATE- MENTS) HAS                                                                                        STATE TAX I.D. NUMBER 
 TRANSMIT THIS RETURN ON OR BEFORE THE                            BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IS TRUE, CORRECT, AND COMPLETE RETURN. IF THE RETURN IS PREPARED BY A 
 20TH DAY OF EACH MONTH FOLLOWING THE                             PERSON OTHER THAN THE TAXPAYER, HIS DECLARATION IS BASED ON ALL THE INFORMATION RELATING TO THE MATTERS REQUIRED TO BE REPORTED IN 
 PERIOD COVERED                                                   THE RETURN OF WHICH HE HAS ANY KNOWLEDGE. 
                                                                 WARNING: DO NOT USE ANY OTHER TAXPAYER'S 
                                                                 RETURN AS THIS WILL RESULT IN IMPROPER CREDIT                                                                                                            DATE            SIGN HERE                                         PHONE NUMBER 
                                                                                                                                                                                                                                                                                             
            Rev. 7/2014 - Present 






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