Form R-3406 "Request to Close Business Tax Accounts" - Louisiana

What Is Form R-3406?

This is a legal form that was released by the Louisiana Department of Revenue - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2011;
  • The latest edition provided by the Louisiana Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form R-3406 by clicking the link below or browse more documents and templates provided by the Louisiana Department of Revenue.

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Download Form R-3406 "Request to Close Business Tax Accounts" - Louisiana

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R-3406 (1/11)
Request to Close Business Tax Accounts
Request must be mailed or faxed to:
Louisiana Department of Revenue
Revenue Processing Center
P.O. Box 201
Baton Rouge, LA 70821
(225) 219-7462 (telephone)
(225) 219-0806 (fax)
Note: A separate form is not necessary if the change applies to all taxes.
Legal Name
Trade Name
Address
City
State
ZIP
I hereby authorize the following account(s) be closed:
Account Number
Close Date
(mm/dd/yyyy)
Sales
Account Number
Close Date
(mm/dd/yyyy)
Withholding
Account Number
Close Date
(mm/dd/yyyy)
Severance
Account Number
Close Date
(mm/dd/yyyy)
Other *
_________________________________________
(Specify)
* Tax accounts other than the types listed above may require additional documentation for closure. Please contact the Louisiana De-
partment of Revenue for more information regarding documentation requirements.
Authorization
Contact Person
Daytime Telephone Number
Signature
Date
(mm/dd/yyyy)
X
R-3406 (1/11)
Request to Close Business Tax Accounts
Request must be mailed or faxed to:
Louisiana Department of Revenue
Revenue Processing Center
P.O. Box 201
Baton Rouge, LA 70821
(225) 219-7462 (telephone)
(225) 219-0806 (fax)
Note: A separate form is not necessary if the change applies to all taxes.
Legal Name
Trade Name
Address
City
State
ZIP
I hereby authorize the following account(s) be closed:
Account Number
Close Date
(mm/dd/yyyy)
Sales
Account Number
Close Date
(mm/dd/yyyy)
Withholding
Account Number
Close Date
(mm/dd/yyyy)
Severance
Account Number
Close Date
(mm/dd/yyyy)
Other *
_________________________________________
(Specify)
* Tax accounts other than the types listed above may require additional documentation for closure. Please contact the Louisiana De-
partment of Revenue for more information regarding documentation requirements.
Authorization
Contact Person
Daytime Telephone Number
Signature
Date
(mm/dd/yyyy)
X