Form Txr-02.01 - Consumer Use Tax Return Form - Nevada Department Of Taxation
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1NEVADA DEPARTMENT OF TAXATION
Certificate No.: 002-
CONSUMER USE TAX RETURN
Please enter your Permit Number
without dashes
For Department Use Only
Mail Original To:
IF POSTMARKED AFTER DUE
Nevada Department of Taxation
DATE, PENALTY AND INTEREST
1550 E. College Parkway
WILL APPLY
Suite 115
Carson City NV 89706
Due on or before:
For
Quarter
ending:
12/31
/05
Due on or before: ________________
IF POSTMARKED AFTER DUE DATE,
PENALTY AND INTEREST WILL APPLY
see
0
IF LATE, ENTER NUMBER OF MONTHS______
instructions
If the name or address as shown is incorrect, if ownership
has changed, or if you are out of business, notify a
Department of Taxation District Office immediately.
A RETURN MUST BE FILED EVEN IF NO TAX LIABILITY EXISTS
ENTER AMOUNTS IN
AMOUNT SUBJECT TO USE TAX
TAX RATE
CALCULATED TAX
COUNTY OF USE
TAX CALCULATION
COLUMN A
X COLUMN B
= COLUMN C
FORMULA
7.250%
0.00
01 CHURCHILL
7.750%
0.00
02 CLARK
0.00
03 DOUGLAS
6.750%
04 ELKO
0.00
6.500%
05 ESMERALDA
6.500%
0.00
06 EUREKA
6.500%
0.00
07 HUMBOLDT
6.500%
0.00
08 LANDER
6.750%
0.00
09 LINCOLN
6.750%
0.00
10 LYON
6.500%
0.00
11 MINERAL
6.500%
0.00
12 NYE
0.00
6.750%
7.000%
0.00
13 CARSON CITY
14 PERSHING
6.500%
0.00
0.00
15 STOREY
7.250%
0.00
7.375%
16 WASHOE
17 WHITE PINE
7.125%
0.00
TOTALS
I HEREBY CERTIFY THAT THIS RETURN INCLUDING ANY ACCOMPANYING
0.00
18. TOTAL CALCULATED TAX (COLUMN C)
18.
SCHEDULE AND STATEMENTS HAS BEEN EXAMINED BY ME AND TO THE BEST
OF MY KNOWLEDGE AND BELIEF IS A TRUE, CORRECT AND COMPLETE
0.00
19. ENTER COLLECTION ALLOWANCE (0.5% OF LINE 18 IF TIMELY, 0% IF LATE)
19.
RETURN.
0.00
RETURN MUST BE SIGNED
20. NET TAXES (LINE 18 MINUS LINE 19)
20.
0.00
21.
21. PENALTY (10% OF LINE 20)
_______________________________________________________________
SIGNATURE OF TAXPAYER OR AUTH. AGENT
0.00
22. INTEREST (1% OF LINE 20) FOR EA. MO. OR PART OF MO.PAST DUE
22.
_______________________________________________________________
23. PLUS LIABILITIES ESTABLISHED BY THE DEPARTMENT
23.
TITLE
PHONE NUMBER (WITH AREA CODE)
24. LESS CREDIT(S) APPROVED BY THE DEPARTMENT
24.
_______________________________________________________________
FEDERAL TAX IDENT NO.
DATE
0.00
25. TOTAL AMOUNT DUE AND PAYABLE
25.
26. TOTAL AMOUNT REMITTED WITH RETURN
26.
MAKE CHECKS PAYABLE TO NEVADA DEPARTMENT OF TAXATION
*001123105000000*
CONSUMER USE TAX RETURN
TXR-02.01
Revised 10-1-05
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