Lafourche Parish School Board MAKE CHECK PAYABLE TO REMITTANCE BOX
Sales and Use Tax Department LAFOURCHE PARISH SCHOOL BOARD
Physical Address 701 East 7th Street, Thibodaux, LA 70301 SALES TAX DEPARTMENT
Local P. O. Box P. O. Box 997, Thibodaux, LA 70302 P. O. BOX 54585
Remittance P.O. Box P. O. Box 54585, New Orleans, LA 70154 NEW ORLEANS, LA 70154
Phone (985) 446-4023
Fax (985) 446-4027
Web Address www.lpsd.k12.la.us Parish Account #
State Account #
DO NOT USE STAPLES Period Ending
USE ONLY FOR PERIOD AND LOCATION INDICATED ON FORM Filing Status
Gross Sales of Tangible Personal Property, Leases, FINAL RETURN (please check)
01 Rentals & Services reported to the State of Louisiana
ALLOWABLE DEDUCTIONS Please Indicate Below if Final Return
02 Sales for Resale DATE BUSINESS CLOSED
03 Cash Discounts, Returned Merchandise, Allowances DATE BUSINESS SOLD
04 Sales Delivered Outside this Parish NAME OF NEW OWNER
05 Sales of Gasoline and Motor Fuels
06 Sales to US Gov't and State of Louisiana ADDRESS OF NEW OWNER
OTHER DEDUCTIONS Authorized by Law (Itemized)
07 USDA Food Stamps or WIC Vouchers
08 Direct Pay Permit Sales COMMENTS
09 Other (Explain)
10 Other (Explain) THIS RETURN IS DUE ON THE 1ST DAY OF THE MONTH
11 Allowable Deductions (sum of Line 2 thru line 10) FOLLOWING PERIOD COVERED BY THE RETURN AND
BECOMES DELINQUENT ON 21ST DAY.
12 Adjusted Gross Sales (Line 1 less Line 11)
Town of Golden Consolidated District Road District 2 South Road District 2 North
COMPUTATION OF SALES AND USE TAX Meadow City of Thibodaux Town of Lockport A Rd Dist 3, 5, & 6 of Intracoastal Canal of Intracoastal Canal
Includes 1% Levee Tax Includes 1% Levee Tax
5.40% 4.95% 5.15% 5.15% 5.40% 4.65%
13 Adjusted Gross Sales in Each Jurisdiction (Totals to line 12)
14 Purchases Subject to Use Tax Each Jurisdiction
15 Total Subject to Tax (line 13 plus line 14)
16 Tax Calculated (Multiply by % shown)
17 Excess Tax Collected, by location
18 Total (Line 16 plus Line 17)
19 Vendor's Compensation (1.1%,Line 18)
20 Net Tax Due (Line 18 minus Line 19)
21 Penalty (5% per month late) Max-25%
22 Interest (1% each month past due)
23 Total Tax, Penalty & Interest (Sum of Line 20, 21 & 22)
24 Tax Debit or Credit (Authorized Debit must be attached)
25 Total Amount Due( Line 23 plus or minus line 24)
I declare under the penalties for filing false reports that this return (including any accompanying schedules or statements, has been
examined by me and to the best of my knowledge and belief is a true, correct return. If the return is prepared by other than the taxpayer, 26 REMITTANCE ATTACHED
the declaration is based on all the information relating to the matters required to be reported of which he has knowledge. (TOTAL OF ALL COLUMNS)
DATE AUTHORIZED SIGNATURE TITLE SIGNATURE OF PREPARER OTHER THAN
TAXPAYER
WARNING: DO NOT USE ANY OTHER TAXPAYER'S RETURNS AS THIS
WILL RESULT IN IMPROPER CREDIT
For Office Use Only Revised 07/2016