Colorado Springs Consumer Use Tax Return

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SALES TAX
COLORADO SPRINGS
CITY OF COLORADO SPRINGS
CONSUMER USE
DEPARTMENT 2408
DENVER, CO 80256-0001
TAX RETURN
(719) 385-5903
MO. — MO.
YR.
MO. — DA.
YR.
USE FOR ALL REFERENCE
DUE
ACCOUNT
PERIOD
DATE
NUMBER
COVERED
SCHEDULE – A
<
TAXPAYER
-SPECIAL MESSAGE TO AND FROM
CITY
SEE REVERSE SIDE FOR INSTRUCTIONS
RETURN MUST BE FILED EVEN IF NO TAX IS DUE
COLUMN A
COLUMN B
COLUMN C
COLUMN D
COLUMN E
DATE OF
NAME OF
TYPE OF PROPERTY/SERVICE
PURCHASE PRICE
PURCHASE PRICE
PURCHASE
VENDOR
PURCHASED
(TAX PAID)
(TAX DUE)
À
LIST PURCHASES (if additional space is needed, attach separate sheet)
$
$
$
TOTAL
$
TOTAL
BALANCE FORWARD FROM ATTACHMENT – IF NONE ENTER -0-
Column D
Column E
TOTAL PRICE OF PURCHASES SUBJECT TO CITY USE TAX
$
$
Column E
COMPUTATION OF TAX
Total Only
AMOUNT OF CITY USE TAX (
OF LINE 3)
$
u
PENALTY: 10% OF TAX
LATE FILING
IF RETURN IS FILED
ENTER
ADD
Line 5 Total
AFTER DUE DATE THEN
TOTAL
$
INTEREST:
Line 4 & 5 Total
$
TOTAL CITY USE TAX AND PENALTY AND INTEREST (LINE 4 & LINE 5)
u
$
ADJUSTMENT
A. ADD: UNDERPAYMENT DUE CITY
w
ATTACH LETTER OF OVER
OR UNDERPAYMENT
PRIOR PERIODS
$
B. DEDUCT: AUTHORIZED CREDIT ALLOWANCE DUE YOU
TOTAL DUE
TOTAL DUE — MAKE CHECKS OR MONEY ORDERS PAYABLE TO CITY OF COLORADO SPRINGS
$
I hereby certify, under penalty of perjury, that the statements made herein are to be the best of my knowledge true and correct.
SIGN BELOW
PAY THIS AMOUNT
NAME OF BUSINESS
SIGNATURE OF TAXPAYER OR AGENT
TITLE
DATE
EMAIL
}
CHANGE OF OWNERSHIP,
NAME, AND/OR ADDRESS, ETC.
… Business Address
ST 100 REVISED 10/2011
… Mailing Address
Additional information on backside

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