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PARISH OF ST. BERNARD
SALES AND USE TAX DEPARTMENT
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P.O. Box 168
CHALMETTE, LOUISIANA 70044
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WARNING:
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DO NOT use any other taxpayer’s return as this will result in improper credit
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TO AVOID PENALTIES RETURN MUST BE TRANSMITTED ON OR BEFORE THE 20TH DAY FOLLOWING THE PERIOD COVERED
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Make checks Payable to:
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Account #
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JACK A. STEPHENS
Sheriff and Tax Collector
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Business Name
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Address
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Signature of owner officer or agent
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City / State / Zip
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SALES AND USE TAX DEPARTMENT
504-271-2504
SALES AND USE TAX RETURN
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Signature of preparer other than taxpayer
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MONTH
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YEAR
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Date
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1.
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GROSS SALES OF TANGIBLE PERSONAL PROPERTY
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2.
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LEASES, RENTALS, AND SERVICES
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3.
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COST OF TANGIBLE PERSONAL PROP
(Used, consumed, stored for, use or consumption in ST. BERNARD PARISH)
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4.
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TOTAL OF ITEMS 1,2 AND 3
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ALLOWABLE DEDUCTIONS
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5.A.
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SALES FOR RESALE
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B.
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SALES OUTSIDE OF ST. BERNARD PARSISH
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C.
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SALES FOR FURTHER MANUFACTURE
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D.
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SALES TO THE UNITED STATES GOVERNMENT
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E.
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CASH DISCOUNTS, SALES RETURNS AND ALLOWANCES
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F.
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SALES IN INTERSTATE COMMERCE
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G.
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FERTILIZER, INSECTICIDES, FUNGICIDES, PESTICIDES,AND
SEED SOLD DIRECT TO FARMERS
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H.
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SALES OF GASOLINE (Special fuels if 20 cent road tax has been paid)
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I.
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ANY OTHER DEDUCTIONS AUTHORIZED BY LAW (Itemize)
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J.
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TOTAL ALLOWABLE DEDUCTIONS (Enter at item 6)
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6.
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LESS ALLOWABLE DEDUCTIONS (Item 5A through I)
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7.
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AMOUNT TAXABLE (Item 4 minus Item 6)
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8.
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9.
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EXCESS TAX COLLECTED
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10.
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TOTAL (Item 8 plus Item 9)
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11.
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VENDOR’S COMPENSATION
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12.
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AMOUNT TAX DUE (Item 10 minus Item 11)
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13.
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TAX DEBIT OR CREDIT (Authorized memo must be attached)
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14.
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DELINQUENT PENALTY
(5% of Tax for each 30 days or fraction thereof of delinquency, not to exceed 25% of the aggregate)
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15.
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INTEREST: (15% per annum from due date until paid)
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16.
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TOTAL TAX, PENALTY AND INTEREST DUE
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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 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.
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