Monthly Utility Occupation Tax Return Form Lynden Washington

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MONTHLY UTILITY OCCUPATION TAX RETURN
MONTH
CITY OF LYNDEN
YEAR
FINANCE DEPARTMENT
323 FRONT STREET
LYNDEN, WA 98264
FIRMS NAME
ADDRESS
The utility tax shall be due and payable to the Ctiy of Lynden in monthly installments, and remittance thereof shall be made to
the Finance Director on or before the last day of the month succeeding the end of the monthly period in which the tax accrued.
UTILITY OCCUPATION TAX
LINE
NO.
1
TOTAL GROSS INCOME DURING ABOVE PERIOD
2
TRANSACTIONS IN INTERSTATE COMMERCE
3
BUSINESS WITH THE U.S. GOVERNMENT PAID TO THE U.S. OR STATE
OF WASHINGTON AS EXCISE TAXES ON GROSS INCOME REPORTED ABOVE
4
OTHER AUTHORIZED DEDUCTIONS
5
TOTAL AUTHORIZED DEDUCTIONS Add lines 2, 3 and 4
TAXABLE
TAX DUE
AMOUNT
RATE
6
INCOME SUBJECT TO 6% TAX Subtract line 5 from 1
.0600
7
INCOME SUBJECT TO 1% TAX As per Ordinance
.0100
8
SUB TOTAL
Add lines 6 and 7
PENALTIES
RATE
ACCRUED TAX
PENALTY DUE
9
Between 1-30 days delinquent from due date
.0100
10 Between 31-60 days delinquent from due date
.0200
11 Between 61-90 days delinquent from due date
.0300
12
TOTAL PENALTY
13 TOTAL TAX REMITTANCE ATTACHED
Add lines 8 and 12
I declare under penalties of perjury that the above return is true, correct, and complete to the best of my knowledge and
belief. I understand that our records are subject to audit by the City of Lynden.
Signed: __________________________ Date: ________________________________
By: _____________________________ Title: ________________________________
ORDINANCE NO. 1177
UOTFORM.XLS

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