PARISH OF TERREBONNE Sales and Use Tax Report TO FILE AND PAY ONLINE:
Sales and Use Tax Department parishe-file.revenue. louisiana .gov
secure.salestaxonline.com
THIS RETURN DUE ON THE 1ST
DAY OF THE MONTH FOLLOWING
PERIOD COVERED BY THE
RETURN AND BECOMES
To avoid penalties this return should be DELINQUENT ON 21ST DAY.
transmitted on or before
the 20th of each month following the
period covered.
PERIOD COVERED
Gross sales of tangible personal property, leases, rentals, and
services as reported to the State of Louisiana. PLEASE INDICATE ANY CHANGES BELOW
ALLOWABLE DEDUCTIONS Date Out-Of-Business Date Business Sold
2 Sales for resale. I
3 Cash discounts, sales returns, & allowances. Name of Purchaser
4 Sales delivered or shipped outside this parish.
5 Sales of gasoline and motor fuels. Mailing Address Change
6 Sales to U.S. Gov't., State of LA & its political sub.& agencies
7 Food paid for with USDA food stamps or WIG vouchers. Location Address Change
OTHER DEDUCTIONS Authorized By Law. (explain briefty)
a Change in Name of Business
9
10
11 Total allowable deductions Cline 2 thru 10). ~II
COMPUTATION OF SALES AND USE TAX
12. ADJUSTED GROSS SALES (Line 1 minus line 11 l
13.
14. PURCHASES SUBJECT TO USE TAX IN TERREBONNE PARISH
15. TOTAL (Line 12 olus line 14)
16. TAX (5.5% OF LINE 15)
17. EXCESS TAX COLLECTED
18. TOTAL (Line 16 olus line 17)
19. VENDOR'S COMPENSATION <2% of line 18 - deductible onlv when payment is not delinquent)
20. NET TAX DUE (Line 18 minus line 19)
21 DELINQUENT PENAL TY (5% of tax on the date the return becomes delinquent, with an addrtional 5% for each subsequent 30-day period, not to exceed 25% in the aggregate)
22. INTEREST 1.0329% of tax oer dav from the first dav of the month following period covered by the return, 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)
I declare under the penalties for filing false reports that this return (including any accompanying schedules and statements) has been LOUISIANA TAX IDENTIFICATION NO:
examined by me andto the best ofmy knowledge and belief isa true, correct,and complete return Ifthe return isprepared by aperson
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.
AUTHORIZED SIGNATURE DATE SIGNATURE OF PREPARER OTHER THAN TAXPAYER DATE REVIEWED BY
WARNING: DO NOT USE ANY OTHER TAXPAYER'S MAIL TO: FOR TAXPAYER ASSISTANCE CONTACT:
RETURN AS THIS WILL RESULT IN IMPROPER CREDIT
Terrebonne Parish Sales & Use Tax Dept. 985-876-3734 PHONE
MAKE SURE return and check is dated and signed P.O. Box670 985-876-9841 FAX
Make all remittances payable to PARISH SALES TAX FUND Houma, LA 70361-0670 salestax@tpcg.org EMAIL