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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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