SABINE PARISH SALES AND USE TAX COMMISSION                                                                                                                                                                               SALES AND USE TAX REPORT
  P.O. BOX 249, MANY, LA  71449
  www.lataonline.org
                                                                                                                                             TAXPAYER'S NUMBER

                                                                                                                                                                                                                                              Office Use Only

                                                                                                                                             Month of:  __________________________
                                                                                                                                             Frequency:
1. Gross Sales of Tangible Personal Property, Leases, Rentals and Services as Reported to the State of 
Louisiana. (Before Taxes)
                        ALLOWABLE DEDUCTIONS
                                                                                                                                             Phone  (318) 256-6219
2. Sales for Resale or Further Processing (Certificate on File)                                                                                                                                  State Tax ID: _____________________
3. Cash Discounts, Sales Returns & Allowances                                                                                                Fax  (318) 256-9794
4. Sales Delivered or Shipped outside Sabine Parish
5. Sales of Gasoline and Motor Fuels                                                                          PLEASE INDICATE ANY CHANGES BELOW:
6. Sales to the U.S. Gov't, the State of LA, its Political Subdivisions & Agencies                                                           FINAL RETURN               CLOSED DATE: ____/_____/____
7. Sales of Food Paid for with USDA Food Stamps or WIC Vouchers                                               NAME OF NEW OWNER: _____________________________________  EMAIL: _______________________________
                                                                                                              COMMENTS:________________________________________________________________________________________
OTHER DEDUCTIONS AUTHORIZED BY LAW (EXPLAIN BRIEFLY)                                                          ____________________________________________________________________________________________________
8.                                                                                                            ____________________________________________________________________________________________________
9.
10.
11. Total Allowable Deductions (Line 2 through 10)                                                                                                                 COMPLETE ONLY THOSE COLUMNS IN WHICH TAXABLE ACTIVITY OCCURS
12. Adjusted Gross Sales (Line 1 minus Line 11)
                                                                                                       A                                    A-1                       B                          C                         D                     E                         F                        
                                                                                                       Many                                  School Dist. #34      School Dist. #2               Zwolle                    Converse              Florien                   Pleasant Hill      
           COMPUTATION OF SALES AND USE TAX                                                            5.625% 4.625%                                                  4.625%                     6.625%                    5.625%                5.625%                    5.625%
13. Adjusted gross sales in each jurisdiction (Total of columns must equal line 12).
14. Purchases subject to use tax in each jurisdiction.
15. Total (Line 13 plus 14).
16. Tax Due (Multiply Line 15 by % shown in column).
17. Excess Tax Collected
18. Total (Line 16 plus 17)
19. Vendor's Compensation (1% 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 Days or Fraction thereof of Delinquency, Not to 
exceed 25%.
22. Interest 1% per month Calculated from Date Due until Paid.
23. Total Tax, Penalty and Interest Due
24. Tax Debit or Credit (Authorized Memo Must be Attached).
25. Total Amount Due (Line 23 plus or minus Line 24).
   Signature of Owner or Agent __________________________________                                                                            Date  __________________                                                      Total Remittance  ___________________
                                                                                                                                             Phone  __________________                                                     Check Number  ___________________