St. John the Baptist Parish 
                                                                                                                                                     Amended:  
                                                            SALES AND USE TAX RETURN
                                                                                              Period Ended: 
                                                                                                                                             
                                                                                              Parish Tax Account No.:                            Filing Status: 
                                                                                                
                                                                                              LA State Tax No.:                                  Federal Tax ID No.: 
                                                                                                
 1    Gross sales of tangible personal property, leases, rentals, and services                                                                1      $ 
                                                  ALLOWABLE DEDUCTIONS                                                                                
 2    Sales for resale                                                                                                                        2      $ 
 3    Cash discounts, sales returns and allowances                                                                                            3      $ 
 4    Sales delivered outside the Parish                                                                                                      4      $ 
 5    Sales of gasoline and special fuels                                                                                                     5      $ 
 6    Sales to U.S. Government, State of Louisiana, & political subdivisions                                                                  6      $ 
 7    Food paid for with USDA food stamps & WIC                                                                                               7      $ 
                              OTHER DEDUCTIONS  UTHORIZED A       Y BAW L EXPLAIN( )                                                                  
 8                                                                                                                                            8      $ 
 9                                                                                                                                            9      $ 
 10                                                                                                                                           10      
 11   Total allowable deductions (Add Line 2 through 10)                                                                                      11     $ 
 12   Adjusted gross sales (Line 1 minus Line 11)                                                                                             12     $ 
                              COMPUTATION OF SALES AND USE TAX                                                                                        
 13                                                                                                                                                   
 14   Cost of tangible personal property subject to use tax in the Parish                                                                     14     $ 
         (Used, consumed, or stored for use or consumption)                                                                                       
 15   Total (Add Lines 12 through 14)                                                                                                         15     $ 
 16   Tax due    Multiply Line 15 by >       5.25% after June 30 2017, or 5.0% if before July 1, 2017                                         16     $ 
                                                                                                                                             16A 
 16A  Exempt sales (DO NOT INCLUDE SALES DEDUCTED ON LINE 17)               $                        X 1% =                                          $ 
         Sales of food for preparation in the home, drugs, insulin, orthotic prosthetic devices, and patient aids prescribed by physicians,       
             dentists, or licensed chiropractors) 
 16B  Net tax due                                                                                                                            16B     $ 
 17   Excess tax collected                                                                                                                    17     $ 
 18   Total tax due (Line 16b plus Line 17)                                                                                                   18     $ 
 19   Vendors compensation                        If not delinquent, multiply Line 18 by>         2% (.02)                                    19     $ 
 20   Net tax due (Line 18 minus Line 19)                                                                                                     20     $ 
 21   Late Penalty (5% per month; maximum 25%)                                                                                                21     $ 
 22   Interest (15% per annum)                                                                                                                22     $ 
 23   Total tax, penalty, and interest due (Add Lines 20, 21, 22)                                                                             23     $ 
 24   Tax debit or (credit) – Authorized memo must be attached to return when filed                                                           24     $ 
 25   Total amount due                                                                     PAY THIS  MOUNTA  :                                25     $ 
      DUE ON 20 THDAY OF MONTH FOLLOWING END OF PERIOD                                   REFUND(CREDIT  ) DUE:                                25     $ 
 26                                                                                           CHECK NUMBER   :                                
      Acct. No.:                                 Tax Period 
 
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 the information relating to the matters required to be reported in the return of which he has any knowledge.
      
Signature                                                    Date          Preparer Signature                                                           Date 
       Make all remittances payable to St. John the Baptist Parish Sales and Use Tax Office. 
       Make sure return and check are signed and dated. 
       Mail to:  St. John the Baptist Parish Sales and Use Tax Office, P. O. Box 2066, LaPlace, Louisiana 70069-2066 
       Returns and payments are due not later than the 20 thday of the month following the end of the tax reporting period.