St. James Parish School Board 
                                     Sales & Use Tax Department 
                                     P.O. Box 368 Lutcher, LA 70071 
                     Phone: (225) 258-4500 ext. 4551 / Fax: (225) 869-8845 
                                                       
                                     Claim for Refund of Taxes Paid 
 
Check Type of Tax to be Refunded:     
   Sales/Use Tax            River Parish Tourist Commission Hotel/Motel Occupancy Tax 
 
Name of Business: 
 
Contact Person Name: 
 
Contact Person Email Address: 
 
Mailing Address:  
 
City                   State               Zip 
 
Physical Address: 
 
City                   State               Zip 
 
Telephone Number:                          Fax Number: 
 
Parish Account Number: 
 
Period(s) of Overpayment:  
 
Total Tax Remitted for the Period(s)       $ 
 
Amount Claimed to be Due as Amended        $ 
 
Difference (Refund Amount Requested)       $ 
 
In  order  to process  the  refund,  please  submit  this  claim  form  along  with  the  following  supporting 
documentation to our office: 
  1.  A written description detailing the reason(s) for the claim in accordance with LA R.S. 47:337.77.  Please 
      include the name of the appropriate contact person with an email address and phone numbers including fax. 
  2.  Tax Accrual Journals, General Ledgers, Work Papers and or Spreadsheets documenting gross/taxable sales, 
      deductions and taxable purchases reported on the St. James Parish sales tax return for the period(s) in an 
      electronic format such as Microsoft Excel or PDF. 
  3.  Copy of original invoice(s) evidencing the invoice date, sale amount and taxes collected from / billed to 
      your customer(s) including proof of payment. 
  4.  Copy of credit memoranda or refund check issued to your customer(s) for the invoice(s) referenced in items 
      2 and 3. 
  5.  Customer(s) State of Louisiana and / or St. James Parish sales tax exemption certificate, if applicable.  Out 
      of state exemption certificates do not qualify. 
  6.  For bad debt write-offs, please provide a copy of the Louisiana Department of Revenue approval letter. 
 
FOR OFFICE USE ONLY:   
Total Approved for Payment  $______________
 
Approved By __________________________
 
Date  ________________________________
  
Rev 05/2011                                                        Claim for Refund of Taxes Paid.doc