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    NATCHITOCHES TAX COMMISSION                                                                                                                                                    SALES AND USE TAX REPORT
    220 East Fifth Street • P.O. Box 639
    Natchitoches, Louisiana 71458-0639

    MAKE YOUR REMITTANCE                                                                                                                                                           PERIOD COVERED ___________________20______
    PAYABLE TO:
    NATCHITOCHES TAX COMMISSION                                                                                                                                                        CONSOLIDATED SALES & USE TAX REPORT FOR NATCHITOCHES PARISH 
    P.O. Box 639                                                                                                                                                                       COMPLETE ONLY COLUMNS IN WHICH TAXABLE ACTIVITY OCCURS
    Natchitoches, Louisiana 71458-0639                                             COMPUTATION OF SALES & USE TAX                                              A - 4.0%   B - 5.5%     BA - 6.5%    BC - 6.5%    BD - 6.5%
                                                                                                                                                               Sales Tax               Natchitoches Natchitoches Natchitoches
                                                                                                                                                               District 1 Natchitoches       EDD A  EDD C        EDD D
GROSS SALES OF TANGIBLE PERSONAL PROPERTY, LEASES,                                 13. ADJUSTED GROSS SALES 
RENTALS & SERVICES AS REPORTED TO THE STATE OF LA    $                                    (Total of columns must equal line 12)
                                                                                   14. PURCHASES SUBJECT TO USE TAX IN EACH 
    ALL O W ABLE DEDUC TIONS                                                              JURISDICTION
2. SALES FOR RESALE OR FURTHER PROCESSING                                          15. TOTAL (Line 13 plus Line 14)
3. CASH DISCOUNTS, SALES RETURNS & ALLOWANCES                                      16. TAX DUE  
                                                                                         (Multiply line 15 times tax rate in each column)
4. SALES DELIVERED OR SHIPPED OUTSIDE NATCHITOCHES PARISH                          17. EXCESS TAX COLLECTED
5. SALES OF GASOLINE AND MOTOR FUELS                                               18. TOTAL (Line 16 plus Line 17)
6. SALES TO TAX EXEMPT GOVERNMENT AGENCIES                                         19. VENDOR’S COMPENSATION (2% of Line 18)
                                                                                         Deductible only when payment is not delinquent.
7. SALES OF FOOD PURCHASED WITH USDA FOOD STAMPS/WIC                               20. NET TAX DUE (Line 18 minus Line 19)
                                                                                    
8. SALES DIRECTLY TO FARMERS OF FERTILIZER, FEED, AND SEED                         21. DELINQUENT PENALTY (5% of tax for each 30 days or fraction              
                                                                                           thereof delinquency not to exceed 25% in the aggregate)
OTHER DEDUCTIONS AUTHORIZED BY LAW (Explain)                                       22. INTEREST (15% per annum from date until paid)
9.                                                                                 23. TOTAL, TAX, PENALTY AND INTEREST DUE
10.                                                                                24. TAX DEBIT OR CREDIT 
                                                                                         (Authorized memo must be attached)
11. TOTAL ALLOWABLE DEDUCTIONS (Lines 2 thru 10)                                   25. TOTAL AMOUNT DUE 
                                                                                         (Line 23 plus or minus Line 24)
12. ADJUSTED GROSS SALES (Line 1 minus Line 11)                                     COMPUTATION OF SALES & USE TAX                                             C - 5.0%   D - 5.0%     E - 5.5%     F - 5.0%     G- 5.0%
                                                                                                                                                               Clarence   Natchez            Campti Robeline     Goldonna
I declare under the penalties for filing false reports that this return (including 13. ADJUSTED GROSS SALES 
any accompanying schedules and statements) has been examined by me                        (Total of columns must equal line 12)
and to the best of my knowledge and belief is a true, correct, and complete        14. PURCHASES SUBJECT TO USE TAX IN EACH 
                                                                                          JURISDICTION
return. 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       15. TOTAL (Line 13 plus Line 14)
to be reported in the return of which he has any knowledge. “Returns               16. TAX DUE  
by taxpayer previously registered by Natchitoches Parish, shall extend                   (Multiply line 15 times tax rate in each column)
registration to all taxing jurisdictions.”                                         17. EXCESS TAX COLLECTED
AUTH. SIGNATURE: ______________________________________________                    18. TOTAL (Line 16 plus Line 17)
                                                                                   19. VENDOR’S COMPENSATION (2% of Line 18)
DATE:___________________  PHONE: _______________________________                         Deductible only when payment is not delinquent.
                                                                                   20. NET TAX DUE (Line 18 minus Line 19)
                                                                                    
To avoid penalties your envelope must have an official                             21. DELINQUENT PENALTY (5% of tax for each 30 days or fraction              
   postmark dated on or before the 20th following the                                      thereof delinquency not to exceed 25% in the aggregate)
    period covered by the return.                                                  22. INTEREST (15% per annum from date until paid)
                                                                                   23. TOTAL, TAX, PENALTY AND INTEREST DUE
    FILE ONLINE: 
                                                                                   24. TAX DEBIT OR CREDIT 
    www.salestaxonline.com                                                               (Authorized memo must be attached)
    www.parishe-file.com                                                           25. TOTAL AMOUNT DUE 
                                                                                         (Line 23 plus or minus Line 24)
                                                                                    26.   REMITTANCE ENCLOSED     (Total for ALL columns)                                                    $






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