P. O. BOX 688
RAYVILLE, LA 71269-0688 ***REVISED FORM***
PHONE (318) 728-0043 * FAX (318) 728-0178 * EMAIL: richlandsalestax@inetsouth.com FOR USE BEGINNING
RICHLAND PARISH: SCHOOL BOARD, SHERIFF, POLICE JURY TAX PERIOD APRIL, 2015
TOWNS: DELHI, MANGHAM, AND RAYVILLE
SALES for MONTH or PERIOD Ended______________________20_____
RICHLAND PARISH SALES/USE TAX REPORT DoForNotRPTCWriteOffice in ThisUseSpaceOnly
ACCOUNT # FILING STATUS: Check Box if AMENDED RETURN:
Check Box if FINAL RETURN:
Closing Date:____________
Check Box if NAME/ADDRESS
CHANGE, Write Correct
Information on Bottom of Return
1. Gross Sales of Tangible Personal Property, Leases, Rentals and Services as Reported to the
State of Louisiana $
ALLOWABLE DEDUCTIONS
2. Sales for Resale $
3. Cash Discounts, Sales Returns & Allowances $
4. Sales Delivered or Shipped Outside of Richland Parish $
5. Sales of Gasoline and Motor Fuels $
6. Sales to the US Govt., State of LA, its Political Subdivisions & Agencies $
7. Sales of Food Paid for with USDA Food Stamps or WIC Vouchers $
OTHER DEDUCTIONS AUTHORIZED BY LAW, LIST BELOW & EXPLAIN
DEDUCTION FOR TAXES PAID NOT ALLOWED
8. $
9. $
11. Total Allowable Deductions (Total of Lines 2 through 9) $
12. Adjusted Gross Sales (Line 1 minus Line 11 – Should Equal Totals Shown on Line 13) $
COLUMN A COLUMN B COLUMN C COLUMN D COLUMN F
COMPUTATION OF TOTAL LOCAL RATE 4% 6.0% 5% 5.5% 2.0%
SALES AND USE TAX MUNICIPALITY TAX PARISH ONLY PARISH + DELHI PARISH + MANGHAM PARISH + RAYVILLE
MPLETE ONLY THOSE PARISH WIDE TAX SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD SCHOOL BOARD
COLUMNS IN WHICH TAXABLE ACTIVITY OCCURS PARISH WIDE TAX POLICE JURY POLICE JURY POLICE JURY POLICE JURY
PARISH WIDE TAX SHERIFF’S OFFICE SHERIFF’S OFFICE SHERIFF’S OFFICE SHERIFF’S OFFICE CONAGRA FOOS
LAMB WESTON, INC.
13. Adjusted Gross Sales in Each Jurisdiction $ $ $ $ $
14. Purchases Subject to Use Tax in Each Jurisdiction $ $ $ $ $
15. Total (Line 13 plus Line 14) $ $ $ $ $
16. Multiply Line 15 by % Shown (Top of Each Column) $ $ $ $ $
17. Excess Tax Collected $ $ $ $ $
18. Total Tax (Line 16 plus Line 17) $ $ $ $ $
19. Vendor’s Compensation (1.5% of Line 18) $ $ $ $ $
20. Net Tax Due (Line 18 minus Line 19) $ $ $ $ $
21. Delinquent Penalty (5% per Month, Max. 25%) * $ $ $ $ $
22. Interest: SEE BELOW ** $ $ $ $ $
23. Total Due (Add Lines 20, 21, and 22) $ $ $ $ $
24. Tax Debit or Credit (Authorized MEMO Attached) $ $ $ $ $
25. Total Amount Due (Line 23 plus OR minus Line 24) $ $ $ $ $
REMITTANCE ATTACHED Have you used the TOTAL REMITTED
(Totals of A,B,C,D,E,F) proper column? Line 26 $
I declare under the penalties for filing false reports that this return (including any accompanying schedule and statements) has been examined by me and to the best of my knowledge and belief is a true, correct and complete return. If a person other than the taxpayer prepares the return, his declaration is
based on all the information relating to the matters required in the return of which he has any knowledge.
INDIVIDUAL OR AGENT NAME_______________________________________________ TITLE____________________ DATE ___________________________
* Penalty is 5% per month , beginning on the 20th day of the month following the period or month reporting, to a maximum of 25%.
** Interest is .0329% daily until date paid, beginning on the 1st day of the month following the period or month reporting. Notes: