Public Utility Report - City Of Baton Rouge
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1CITY OF BATON ROUGE - PARISH OF EAST BATON ROUGE
PUBLIC UTILITY REPORT
For Month or Quarter Ending: ____________________, _______
Business Name:
Address:
Location Address:
East Baton Rouge Parish TAX CODE:
East Baton Rouge Parish ACCOUNT #:
5%
Month
Gross Receipts
Gross Receipts Tax
$
$
$
$
$
$
TOTALS
$
$
The undersigned,
, does hereby swear that the above is a
complete and true exhibit of the operations of the individual or company represented herein.
Name:
Date:
Title:
Phone:
Please return form and remittance payable to: PARISH AND CITY TREASURER
City of Baton Rouge
Finance Department - Revenue Division
P. O. Box 2590
Baton Rouge, LA 70821-2590
Phone: (225) 389-3084
Fax: (225) 389-5369
Base Tax:
$
th
Penalty:
$
Note: Tax due on or before the 25
day
$
of the month following the end
Interest:
of the calendar quarter.
Total:
$
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