R-9006l Form Sev T-1a - Timber Form- T-1a - State Of Louisiana Department Of Revenue

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State of Louisiana
Page_____ of _____
R-9006L (12/03)
Department of Revenue
T-1A
Timber Form- T-1A
Parish Detail – Timber
FORM SEV
P.O. Box 201, Baton Rouge, LA 70821-0201
Tax paid herewith
SEVERANCE TAX TIMBER
Reporting company name
Revenue Account Number
Reporting company address (Including ZIP)
Taxable Period
Name of plant or mill for which the report is filed
File original of this return only.
Column 1
Column 2
Column 3
Column 4
Column 5
Column 6
Column 7
Product
Parish
Name of severer and/or purchaser
Tons severed or
code
code
Name of timber tract or name source
Tax rate
Tax amount due
and complete address
purchased
number
number
$
$
$
$
$
$
$
$
$
$
$
$
$
$

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