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R5629 (9/01) State of Louisiana Department of Revenue Excise Taxes Division P.O. Box 3863 Baton Rouge, LA 70821 (225)9257656 (225)9257533 (TDD) Social Security Number Name Address Consumer Excise
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The r-5629 901 form is a tax form used for reporting certain income or expenses.
Individuals or businesses that meet specific criteria outlined by the tax authorities.
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The purpose of the r-5629 901 form is to report relevant financial information to the tax authorities.
You must report specific income or expenses as outlined on the r-5629 901 form.
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