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1.  Gross Sales of tangible property.  Leases, rentals and Services as reported to the 
State of Louisiana.
                                      ALLOWABLE DEDUCTIONS
2.  Sales For Resale                                                                                                                                         City of Monroe/Ouachita Parish
3.  Cash Discounts, Sales Returns, and Allowances                                                                                                            Taxation and Revenue Division
4.  Sales Delivered or shipped Outside This Jurisdiction                                                                                                                 PO BOX 123
5.  Sales of Gasoline and Motor Fuels                                                                                                                        MONROE, LA 71210-0123
6.  Sales to agencies of the U.S. Govt., the State of LA., and it political subdivisions
7.  Sales of food paid for with USDA Food Stamps or WIC Vouchers
                   OTHER DEDUCTIONS AUTHORIZED BY LAW (EXPLAIN BRIEFLY)
8.
9.
10.
11.  TOTAL ALLOWABLE DEDUCTIONS (Lines 2 through 10)
12.  ADJUSTED GROSS SALES (Line 1 minus Line 11)                                                                            TO AVOID PENALTIES, RETURNS MUST BE TRANSMITTED ON OR BEFORE THE 20TH DAY FOLLOWING THE PERIOD COVERED.
                                                                                             Column 1               Column 4        Column 2 Column 7        Column S    Column 3       Column R                                   Column 8 Column 9        Column 10 Column 11              Column 12        Column 13
                                                                                             City of Monroe            East         City of  West            Town of     City of        City of  City of West                               Town of         Walnut St Walnut St EDD          Mfg/Machinery    Mfg/Machinery
   COMPUTATION OF SALES AND USE TAX                                                          Prescrip. Drug & Foods Ouachita Parish Monroe   Ouachita Parish Sterlington   West Monroe  Richwood Monroe EDD                                 Sterlington EDD  EDD      Prescrip. Drug & Foods     Exemption    Exemption          
                                                                                                                                                                                                                                                                                             West Ouachita    East Ouachita
                                                                                                  4.99%             5.99%           5.99%    5.99%           6.50%       5.99%          5.50%                                      6.99%    8.50%           7.99%     6.99%                  3.99%            3.99%
13.  Adjusted Gross Sales FROM LINE 12 FOR Each Jurisdiction
14.  Purchases Subject To Use Tax In Each Jurisdiction
15.  TOTAL (Line 13 plus line 14)
16.  TAX (Line 15 times applicable %)
17.  Excess Tax Collected
18.  TOTAL (Line 16 plus line 17)
19. Vendor's Compensation (1% of line 18 deductible only when payment is not delinquent)
19a. Vendor's Compensation (2% of line 18 deductible only when payment is not delinquent)
20.  NET TAX DUE (Line 18 minus line 19)
21.  Delinquent Penalty (5% of tax for each 30 day period, beginning the day of the due 
date), not to exceed 25% in the aggregate)
22.  INTEREST 12% per annum / 1.00% per month or a fraction thereof
23.  TOTAL TAX, PENALTY, AND INTEREST DUE
24. Tax Debit or Credit (Authorized Memo Must Be Attached)
25.  TOTAL AMOUNT DUE (LINE 24 PLUS OR MINUS LINE 25)
26. Remittance Attached  

I declare under penalties for filing false reports that this return and attachments has been Signature of Taxpayer                           Signature of Preparer other than Taxpayer
examined by me and to the best of my knowledge & belief is a correct and complete 
return.  If prepared by a person other than the taxpayer, his/her declaration is based on 
all information relating to matters required to be reported in the return of which he/she is Date           Reviewed By                      Contact Phone #
knowledgeable.

                                                            MONTH ENDING                                                                     Final Return as of _________________________
              WARNING!                                                                                                                                       Make Remittance Payable To:
   DO NOT USE ANY OTHER TAX-                                    ACCOUNT NO.:                                                                                 TAXATION AND REVENUE DIVISION
   PAYERS RETURN AS THIS WILL                                                                                                                                P.O. BOX 123
   RESULT IN IMPROPER CREDIT                              ACCOUNT NAME:                                                                                      Monroe, Louisiana  71210-0123






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