R-1341 (7/98) State of Louisiana
Department of Revenue Instructions for Contract Completion Form
General Instructions This form is required to be completed prior to the release of any sure ty bond obtained for any
contract engaged in by a nonresident contractor, as defined in Louis iana Revised Statute 47:9. Failure to
properly complete this form will delay the release or reduction of any bond now held by the Secretary of the
Department of Revenue. Prior to the release or reduction of any bond, verification of tax pa yment and/or settlement of any
tax liability will be requested from all affected taxing authorities, includin g but not limited to, city and parish
sales/use tax authorities; Department of Labor; Office of Employment S ecurity; and related tax sections
within the Department of Revenue. Verification that no tax is due by your company to the affected taxing
authorities will result in the release or reduction of the bond. The bond cannot be terminated or reduced
without written approval by the Secretary of the Department of Revenu e.
A separate contract completion form must be completed for each contra ct.
Line Instructions
1. Contractor/Subcontractor name – List the name(s) of the person(s) or corporation to whom the contract
was let.
2. Mailing address – All information concerning the identified contract will be mailed to this add ress.
3. Representative name and telephone number – List name and telephone number of a contact person if
questions should arise concerning this form.
4. Description and location of facility altered, renovated, or erected – This information should specifically
identify the contract for which this form is being completed. R efer to Section B, Line 1 of Form R-1342, Tax
Registration Number and Contract Information Form. Also include be ginning and ending dates of contract.
5. Original estimated contract amount – This is the estimated contract amount to the person(s) or
corporation for whom this specific contract was performed.
6. Actual contract amount (if different from Line 5) – This is the entire contract amount charged by your
company, (including any change orders) to the person(s) or co rporation for whom this specific contract was
performed.
7. Amount awarded to subcontractors – This is the amount of the contract that was not performed by your
company. A resident contractor is one that is located within the State of Louisiana. A nonresident
contractor is one that is normally located outside Louisiana. An updated list of subcontractors should also
be provided.
8. Construction materials cost – This amount should include the cost of all materials used by yo ur company
that became a component part of the facility whether purchase d in this state or brought into this state for use
in the performance of the contract. (Do not include taxes paid.)
8a. Cost of materials purchased out of state – List that portion of the amount shown on Line 8 that was the
cost of materials purchased out of state and on which sales tax was paid t o another state. (Do not include
taxes paid.)
8b. Tax paid to another state on Line 8a – This is the amount of sales tax paid on the material cost listed o n
Line 8a for which reciprocal credit was claimed. List the state to which this tax was paid and the rate at
which it was paid. (If more than one rate, attach itemized schedule.)
9. Equipment cost – This amount should include the cost of tools, supplies, and equipm ent necessary for
the performance of the contract. This includes anything that did not b ecome a component part of the
contract. (Do not include taxes paid.)
9a. Cost of equipment purchased out of state – List that portion of the amount shown on Line 9 on which
another state’s sales tax was paid. (Do not include taxes paid.)
9b. Tax paid to another state on Line 9a – This is the amount of tax paid on purchases listed on Line 9a for
which reciprocal credit was claimed. List the state to which the sales ta x was paid and the rate. (If more
than one rate, attach itemized schedule.)
10. Equipment rentals – This amount should include all rentals of tangible personal property.
10a. Tax paid to another state on Line 10 – This is the amount of tax paid on rentals listed under Line 10 for
which reciprocal credit was claimed. List the state to which the sales ta x was paid and the rate. (If more
than one rate, attach itemized schedule.)
11. Total Louisiana tax (state and local) paid on construction materials, equip ment, and rentals – This
amount should include total state and local sales/use tax paid (not including those amounts paid to another
state shown on Lines 8b, 9b and 10a). This amount should include tax es paid directly to vendors and use
tax remitted directly to the state. (Line 11 should equal Line 12 plus Lin e 13.)
12. Total Louisiana state tax paid on construction materials, equipmen t, and rentals – This amount is that
portion of Line 11 that represents Louisiana state sales/use paid. (Line 12 should equal Line 14 plus Line
16.)
13. Total Louisiana local tax paid on construction materials, equipment, and rentals (total of city, parish,
police jury, school board, etc.) – This amount equals that portion of Line 11 that represents Lou isiana local
sales/use taxes paid. (Line 12 should equal Line 15 plus Line 16.)
14. Amount of tax paid directly to the State of Louisiana – This amount should reflect the state sales tax
accrued and paid directly to the State of Louisiana and the account number under which it was paid.
15. Amount of tax paid directly to the local taxing authorities – This amount should reflect the total amount of
tax remitted to any local taxing authorities in Louisiana. Identify each authority to whom the tax was remitted
and the account number under which it was paid.
16. Amount of tax paid to vendors – This is the amount of Louisiana sales tax paid directly to you r suppliers
on purchases of materials, equipment, rentals, and supplies ne cessary to perform the job. The amount of
state sales tax paid to your suppliers should be separated from the amount of local t ax and the
correct figure should be listed under the respective headings.
17. Gross payroll – This amount is the total amount of Louisiana state income tax withheld and reported to
this Department for the gross payroll for this project. This figure doe s not include federal income tax
withheld nor does this figure include other states’ income tax on income earned in another state. If no
Louisiana tax was withheld, please explain.
17a. State income tax withheld – Please identify the month and year in which this payroll bega n and ended
and the account number under which the tax was paid.
18. Corporation franchise tax account number – List account number and name under which franchise tax
(if any) was paid.
18a. Estimated franchise taxable base (if any) – This amount is determined as follows: $1.50 per $1,000 of
the first $300,000 of capital stock surplus, undivided profits, and borro wed capital allocated to Louisiana,
plus $3 per $1,000 of capital stock, surplus, undivided profits, and borrowed capital allocated to Louisiana in
excess of $300,000. The allocation formula is based on the arithmetical average of: (1) ratio of net sales
and other revenue attributable to Louisiana to total, and (2) ratio of the value of tangible and intangible
assets located in Louisiana to total. Taxable base shall not be less than th e assessed value of real and
personal property located in Louisiana. Minimum tax is $10.
18b. Income tax account number (if corporation) – Any nonresident and any individual who was a resident
for part of the year and a nonresident the remainder of th e year must report his income from all sources for
the period during which he was a resident, plus all income from Louisian a sources for the period he was a
nonresident. Any corporation deriving income from Louisiana sources must be registered and must file
required returns. List account number if business is incorporated.
18c. Social Security Number – List social security number if business owner is individual.
18d. Account name – List the account name under which taxes were paid.
18e. Estimated tax payments (if corporation) – List estimated tax payments made to this Department during
the period in which the contract was ongoing.
18f. Estimated net income from contract – Estimated net income from this contract only should be listed in
the space provided.
19. Louisiana unemployment insurance account number – As a business employing persons in this state,
you are responsible for the payment of this tax. Please give the account number assigned to you for
remittance of this tax.
19a. Federal Identification Number – Please furnish your Federal Identification Number under whic h federal
taxes are remitted. If you are not liable for this tax, please indicate.
R-1341A (1/02) State of Louisiana
Department of Revenue
Contract Completion Form
1. Contractor/Subcontractor Name
2. Mailing address
City, State, ZIP
3. Representative name
Telephone
4. Description and location of facility altered, renovated, or erected
Description (type of building, name, etc.)
Location (street, city, and parish)
Beginning date Ending date
5. Original estimated contract amount
6. Actual contract amount (if different from Line 5)
7. Amount awarded to subcontractors
Resident $
Nonresident $
Please provide updated list of subcontractors. (See Form R- 1130-L, General Contractor/Subcontractor
List.)
Sales and Use T ax
8. Construction materials cost (Do not include taxes paid.)
8a. Cost of materials purchased out of state (Do not include taxes paid .)
8b. Tax paid to another state on 8a
Tax amount Rate State
9. Equipment cost (Do not include taxes paid.)
9a. Cost of equipment purchased out of state (Do not include taxes paid .)
9b. Tax paid to another state on 9a
Tax amount Rate State
10. Equipment rentals
10a. Tax paid to another state on 10
Tax amount Rate State
11. Total Louisiana tax (state and local) paid on construction materials, equipment, rentals
12. Total Louisiana state tax paid on construction materials, equipment, rentals
13. Total Louisiana local tax paid on construction materials, equipment, rentals (total of city, parish, police
jury, school board, etc.)
14. Amount of tax paid directly to the State of Louisiana
Account number
15. Amount of tax paid directly to the local taxing authorities (Please identify to whom the tax was paid.)
Authority Account number Amount
Authority Account number Amount
Authority Account number Amount
16. Amount of tax paid to vendors
State Local
Job number
Bond number
Release date
State Income Tax Withholding
17. Gross payroll $ Louisiana tax withheld
If no Louisiana tax withheld, please explain.
17a. State income tax withheld
Period (beginning month/year through ending month/year)
Account number (10-digit number)
Corporation Income Franchise/Individual Income Tax
18. Corporation franchise tax account number
18a. Estimated franchise taxable base
18b. Income tax account number (if corporation)
18c. Social Security Number (if individual)
18d. Account name
18e. Estimated tax payments
18f. Estimated net income from contract
Unemployment Insurance Tax
19. Louisiana unemployment insurance account number
19a. Federal Identification Number
The undersigned certifies that the above is a complete and accurate statement of liabilities incurred and
payments made for the Louisiana state and local taxes indicated, p ursuant to the contract identified above.
___________________________________________________ _________
Authorized signature
Date:
___________________________________________________ _________
Notary public
Date
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