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INFORMATION                                                          _________________________________

ame:_________________________________________________           ____________________________________

y                                                               ___________________________________

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Taxpayw ent intoaVoluntaDAgreement                                   “VDA”)ithheParishregardingthe
paymentfocalax.heaxpayeresiresoenullomplianceithheaxawsfhearishy
registeringocollectheocalax,imelyremittingheloca       tadueanremittthdurequiredby

TYPETA   TAGREEMEENT

  Sa                                                                 InsurancePremiuTa

     Occupancy            Other(specify)_________________________________________________

ERIODETAGREEMENT:

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ecompany                  thaas    er                 m         gein toanothcompany?

Dixpaycollectthatremitted?

xpay                      son(s) ha   t                 txes

this

asft                      dpaytaxe                     toPari        pasactivitiexplai

thcorrectaction(staka     oa                            asai

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______________________________________________________________________________________________________________________________

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ame:_________________________________________________    ________

LU

aeiabet_________________                              ____________________________________(Taxp
  Ta ollectorollector).axpayeCollector                mutuallytracandgreeollo

  1. tothxpayis                                          othanatax
     dueotheari hyilisngllpplicationsorales xegi      a  stratiiapplicaboccupational
     ahirt                     ayilingofgree
  2. Taxpayershallprovidedocumentatiodetailinthelotadu                    ebymonthndearwithinhirty
     ilingof
  3. Remit               sales/use     eeginni           fti
     tthi                         yecti                  reement
  4. Taxack              Collector’s authorityoakedeterminationfaxesueoronthsithi
      prescriptive p p b estima cons                                      ents t Co mak a
     determinationfaxesueystimate,oronthsithinhe         p
     tanudit
  5. Regardleotheavailabilityo    ppursuan               ttoL47:337.67Collector
     shallavendetaintheightoxamine,nspect,orauditt       hetax,accountinafin              recordanci
                         odithoutlimitati
  6. ba prescriptpursuanttLAR47:337.67(D)                                 Taxpa
     amounto du                   eithinhirty30)aysfe                     ceiptCollector’sdeterminationo
     mountdtho
  7. Taxpayercknowledgesdrees          hathaccruati                       pursuantto47:337.67(
     notapplandsubtexofthefail                           ureoileaeturnithintentodefraud
     aspbL47:337.67(atfilingofafa                        lserraudulenteturnsrovidedy
     LA
  8. Remitnyoccupation liacenseaxueorheurrentcalendar    yeaattcalenda
     yearccordah
  9. interesta of_             _____tbecomt              firsoft               mfollothe
     cs
  10. s and remit                      a p sales/us                       e/li ta fut peri
     pursuanttRevise              atutesdtarisOrdinances.
  11. E xceptoriscussionsoncerninghisgreement,axpayerepresentshatitasoteen
     contactedating               audotaproced

Taxpayame:_ ________ ____ _______ ____________________________ _            ____________________________________

    12. Taxpa a t into t Ag  g fait abs                                               fr mat
       a                     anys                         t                 wireithisAgreemenbein

    13. Maintainconfidentialiotheteofgreemen 

       dera   forement       ste

    1. Abatecivicrimipena                                 ltagainstTaoi     tsfficersrmployeesorailureo
       registerorheollectionfocalales/useax,heailureoimelyemitocalales/useax,ndhe
       failuretremilicenseta            thcbytAgreement                                  (whicaredefineas
       ecedin             therreriod
    2. toanexceptfcircumstances wLA 47:3                                    37.67( L 47:337.67
             Collectacknoaathabymakin                                       thisvoluntad ag
       Taxpayith                        cc                  rfscri          pursuantA    7:337.67
    3. Maintaidentiality              a                     atti            nghxpay
    4. Enteit

Accepty:_______________________________________________________

Ifheaxpayerhosaartyothegreementsegalers                                 onandotnaturalerson,hepersonigning
thAgreementbeloobehalfoTaxpayrepresentth                                    ate/shesnfficerulyuthorizedoo
sodasthorityomTaxpayeroagreetoermsdo                                        nditionsthisgreement.axpayerlects
appointarepresentativethelawagenanattorney‐in                               ‐facttoepresentaxpayereforehearish,
PoweofAttorne DeclaratioofRepresentative acco                               mpthiAgreemenauthorizinth
representaperfncapacity

                  napayerepresentative

_________________________________________________________               ____
yer                       ntative’s

                  fresentativ