Form 41 Ls PDF Details

Are you familiar with Form 41 LS? This is a Louisiana state tax form that is used to report certain types of income derived from sources within the state. The form must be filed by all individuals and businesses that have income taxable in Louisiana. If you're not sure whether or not your income is taxable in LA, or if you need help completing the form, be sure to contact an accountant or tax professional. Filing this form is important, as it helps ensure that you are paying the correct amount of taxes on your income. With just a few simple steps, you can easily complete Form 41 LS and submit it to the Louisiana Department of Revenue.

Here is the information regarding the form you were looking for to fill in. It can show you the span of time you will need to finish form 41 ls, exactly what fields you will have to fill in and several additional specific facts.

QuestionAnswer
Form NameForm 41 Ls
Form Length1 pages
Fillable?Yes
Fillable fields41
Avg. time to fill out8 min 27 sec
Other namesDOJ, live scan 41 ls form, ATI, live scan 41 ls form pdf

Form Preview Example

REQUEST FOR LIVE SCAN SERVICE

FORM 41-LS Rev. 07/11

Applicant Submission

ORI:

 

 

 

 

 

 

 

 

 

 

 

 

Type of Application:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Code assigned by DOJ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Job Title or Type of License, Certification or Permit:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Agency Address Set Contributing Agency:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Agency authorized to receive criminal history information

 

 

 

 

Mail Code (five-digit code assigned by DOJ)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street No.

Street or PO Box

 

 

 

 

 

 

 

 

 

 

 

 

Contact Name (Mandatory for all school submissions)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

 

 

 

 

Zip Code

 

 

 

 

Contact Telephone No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Applicant:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Please print)

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

First

 

 

 

 

 

 

 

MI

 

 

Alias:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver’s License No:

 

 

 

 

 

 

 

 

 

 

 

Last

 

 

 

 

 

 

 

 

 

 

 

 

First

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth:

 

 

 

 

Sex:

 

 

 

 

Male

 

 

Female

Misc. No. BIL -

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Agency Billing Number

 

Height:

 

 

 

 

Weight:

 

 

 

 

 

 

 

 

 

 

 

 

 

Misc. Number:

 

 

 

 

 

 

 

 

 

Eye Color:

 

 

 

Hair Color:

 

 

 

 

 

 

 

 

 

 

 

 

Home Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street No.

 

 

Street or PO Box

 

Place of Birth:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City, State and Zip Code

 

 

Social Security Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OCA No. (Applicant Social Security No.)

 

 

 

 

Level of Service:

 

 

DOJ

 

FBI

 

If resubmission, list Original ATI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer: (Additional response for agencies specified by statute)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street No.

 

Street or PO Box

 

 

 

 

 

 

 

 

 

 

Mail Code (five digit code assigned by DOJ)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

City

 

State

Zip Code

 

 

Agency Telephone No. (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Live Scan Transaction Completed By:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Operator

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Transmitting Agency

 

 

 

 

 

 

 

 

 

ATI No.

 

 

 

 

 

 

 

 

 

 

 

 

 

Amount Collected/Billed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ORIGINAL – Live Scan Operator; SECOND COPY – Applicant; THIRD COPY (if needed) – Requesting Agency

How to Edit Form 41 Ls Online for Free

We have used the efforts of the best computer programmers to create the PDF editor you may want to begin using. Our software will help you fill out the 41 ls form form effortlessly and don’t waste your time. All you need to do is follow the following straightforward instructions.

Step 1: On the following web page, select the orange "Get form now" button.

Step 2: Now you are able to modify 41 ls form. You have a wide range of options with our multifunctional toolbar - you can add, remove, or customize the content, highlight the certain elements, and carry out many other commands.

The next parts are going to make up your PDF file:

writing DOJ part 1

Write down the data in AgencyBillingNumber, Height, Weight, EyeColor, HairColor, PlaceofBirth, SocialSecurityNumber, YourNumber, OCANoApplicantSocialSecurityNo, IfresubmissionlistOriginalATINumber, EmployerName, MiscNumber, HomeAddress, StreetNo, and StreetorPOBox.

step 2 to entering details in DOJ

The software will ask for additional information as a way to easily prepare the field City, State, ZipCode, AgencyTelephoneNooptional, LiveScanTransactionCompletedBy, NameofOperator, Date, TransmittingAgency, ATINo, and AmountCollectedBilled.

Finishing DOJ part 3

Step 3: After you click the Done button, your ready form can be simply exported to any kind of your devices or to electronic mail provided by you.

Step 4: To protect yourself from probable future risks, it's always advisable to have minimally a couple of duplicates of any form.

Watch Form 41 Ls Video Instruction

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