Name
R-1031 (2/03)
Trade Name
Louisiana Department of Revenue
Direct Marketer Sales Tax Return
Address
Catalogs, Periodicals, Internet, Radio,
Address
Television, or Other Advertising
Taxpayer Services Division
City, State, ZIP
P.O. Box 3863
Baton Rouge, LA
70821-3863
(225) 219-7356
Filing
mm / yy
period
Please enter your Revenue Account Number here.
.00
1
GROSS SALES OF TANGIBLE PERSONAL PROPERTY ............................................. 1
(Through catalogs, periodicals, Internet, radio, television, or by other advertising)
.00
2
TOTAL ALLOWABLE DEDUCTIONS ............................................................................. 2
(From Line 19, Schedule A. Do not include as a deduction any item not reported on Line 1.)
.00
3
TOTAL TAXABLE AMOUNT (Line 1 minus Line 2) ........................................................ 3
.00
4
TAX DUE
4
(Multiply amount on Line 3 by 8%.) ..................................................................................
.00
5
EXCESS TAX COLLECTED
5
.........................................................................................................
.00
6
TOTAL
.................................................................................................. 6
(Line 4 plus Line 5)
.00
7
VENDOR’S COMPENSATION
7
(1.1% of Line 6 if not delinquent) .................................................
.00
8
NET TAX DUE
8
(Line 6 minus Line 7) ..............................................................................................
.00
9 DELINQUENT PENALTY
9
................................................................................................................
(5% of tax for each 30 days of delinquency, or fraction thereof, not to exceed 25% in the aggregate)
.00
10
INTEREST
....................................................................................................................................... 10
(1.25% per month from due date until paid)
.00
Mark this box if
PAY THIS
11
TOTAL TAX, PENALTY, AND INTEREST
.............................................................................. 11
payment made
AMOUNT
(Total of Lines 8, 9, and 10)
electronically.
SCHEDULE A – ALLOWABLE DEDUCTION
.00
PAY THIS
12 SALES OF PREPAID PHONE CARDS
12
......................................................................
AMOUNT
.00
13 MULTIPLY LINE 12 BY 12.5% (.125) AND ENTER HERE. ........................................... 13
.00
14 FOOD ITEMS FOR HOME CONSUMPTION ..................................................... 14
.00
15 MULTIPLY LINE 14 BY 75% (.75) AND ENTER HERE. ................................................ 15
.00
16 PRESCRIPTION DRUGS, INSULIN, ORTHOTIC AND PROSTHETIC DEVICES. ........ 16
.00
17 SALES TO FEDERAL, STATE, LOCAL GOVERNMENT AGENCIES .......................... 17
.00
18 SALES TO REGISTERED WHOLESALERS .................................................................. 18
.00
19 TOTAL (Add Lines 13, 15, 16,17, and 18. Enter here and on Line 2.) ........................... 19
I declare under the penalties for filing false returns that this return (including any accompanying schedules and statements) has
been examined by me, and to the best of my knowledge and belief, it is a true, correct, and complete return.
__________________________________________________________________________________________
___________________________________________
Signature
Date
(
)
_______________________________________________________________________
____________________________________________
Telephone
Preparer signature
ID number of independent preparer
To avoid penalties, return must be transmitted on or before the 20th day following the period covered. If the due date falls on a
weekend or holiday, the return is due the next business day and becomes delinquent the first day thereafter.