TO AVOID PENALTIES RETURN
              ST. JAMES PARISH SCHOOL BOARD                                                                                     MUST BE TRANSMITTED ON OR
              SALES AND USE TAX DEPARTMENT                                                                                 BEFORE THE 20TH DAY FOLLOWING
                                                                                                                                  THE PERIOD COVERED
              P.O. Box 368
              Lutcher, LA 70071-0368
              Phone: (225) 258-4551                                                                                        DO NOT use any other taxpayer's return
              Fax: (225) 258-8105                                                          WARNING                         as this will result in improper credit.
              Email: salestax@stjames.k12.la.us

              Account Number: _________________                                            Tired of filing your sales/use tax return by mail
                                                                                           with a check?  Use online filing with ACH Debit!
              Name____________________________________                                     Visit https://parishe-file.revenue.louisiana.gov to
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              Address___________________________________

              City, State Zip Code _________________________

                                                                    CHANGE OF STATUS REPORT
Date Business Discontinued                       Date Business Sold                 Name of Purchaser

Business Location Change                              Mailing Address Change                              Change in Name of Business

Type (Ind. Corp, LLC, LLP, etc.)          Other                                     Signature and Title of Preparer

COMPLETE ABOVE SECTION IF:
                                                                                           STATE TAX ID#
1.  There has been a change in ownership.        ST. JAMES PARISH SCHOOL BOARD
2.  There is a change in address.
3.  Business has been discontinued.                 SALES AND USE TAX RETURN                                                                                               18
                                                                                           PERIOD ENDING                                                               20
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 ST. JAMES PARISH
5. SALES OF GASOLINE OR MOTOR FUELS
6. SALES TO U.S. GOVERNMENT, STATE OF LA & ITS POLITICAL SUBDIVISIONS AND AGENCIES
7. FOOD PAID FOR WITH U.S.D.A. FOOD STAMPS OR WIC VOUCHERS
                   OTHER DEDUCTIONS AUTHORIZED BY LAW (EXPLAIN BRIEFLY)
8.
9.
10.
11. TOTAL ALLOWABLE DEDUCTIONS (line 2 thru 10)
12. ADJUSTED GROSS SALES (line 1 minus line 11)
                            USE PROPER COLUMN(S)
IMPORTANT: ADJUSTED GROSS SALES ON LINE 12 MUST BE BROKEN DOWN TO THE APPLICABLE    OUTSIDE INCORPORATED      TOWN OF GRAMERCY                             TOWN OF LUTCHER
             COLUMNS ON LINE 13 FOR PROPER DISTRIBUTION WITHIN THE PARISH.          MUNICIPALITY AREAS        INCORPORATED AREA                            INCORPORATED AREA
                         (LINE 13 COLUMNS A + B + C = LINE 12)                    A 3.5%                 B                 4.0% ONLY  C                                4.5%
13. ADJUSTED GROSS SALES IN EACH JURISDICTION
14. PURCHASES SUBJECT TO USE TAX IN EACH JURISDICTION
15. TOTAL (line 13 plus line 14)
16.  TAX: LINE 15 COL. A x 3.5%;  LINE 15 COL. B x 4.0%;  LINE 15 COL. C x 4.5%
     Total Sales, Purchases, Leases or Rentals Included on Line 15 Subject to the
     Manufacturing Machinery & Equipment Exclusion (Businesses with NAICS Code
16a. 331111 - Iron & Steel Mills) - Column A only
16b. 1% St. James Parish Council MM&E Exclusion (Line 16a x 1%)
16c. NET TAX DUE (Line 16 minus Line 16b)
17. EXCESS TAX COLLECTED
18. TOTAL (COL A: Line 16c plus line 17; COL B and C: Line 16 plus Line 17)
19. VENDOR'S COMPENSATION (1.5% of line 18 if 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% in the aggregate)
22. INTEREST (1% per month from due date 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)
26. REMITTANCE ATTACHED: (columns A, B, C (line 25)             $                   MAKE REMITTANCE PAYABLE TO - ST. JAMES PARISH SCHOOL BOARD.
                I declare under the penalties for filing false reports that this return (including any accompanying schedules and statements) has been examined by me
                 and to the best of my knowledge and belief is a true, correct and complete return.  If the return is prepared by a person other than the taxpayer, his
                       declaration is based on all information relating to the matters required to be reported in the return of which he has any knowledge.
DATE                     SIGN HERE                                               SIGNATURE OF PREPARER OTHER THAN TAXPAYER      REVIEWED BY

Revised 7/1/2018