Sales / Use Tax Return Form
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1City Sales Tax # __________________
Vendor Name ______________________________________
P. O. Box 4000
Address, City State Zip ______________________________
Sterling, CO 80751
__________________________________________
(970) 522-9700
FAX (970) 521-0632
Sales / Use Tax Return
Period End Date ________________ Due 20th of next month
1. Gross Sales and Services
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2. Add: Bad Debts Collected
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3. Total Lines 1 + 2
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4. Deductions:
A. Non-Taxable Service Sales (included in Line 1)
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B. Sales to Other Dealers for Resale
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C. Sales Shipped Out of City
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D. Bad Debts Charged Off
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E. Trade-Ins for Taxable Resale
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F. Sales of Gasoline and Cigarettes
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G. Sales to Government, Religious, Charitable .
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H. Returned Goods
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I. Prescription Drugs
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J. Other (must be identified) ________________________
K. _____________________________________________
L. _____________________________________________
Total Deductions (Lines 4A thru 4L)
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5. Net Taxable Sales & Services (Line 3 less "Total Deductions") .
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6. Amount of City Tax: 3% (0.03) of Line 5
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7. Add: Excess Tax Collected
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8. Total Sales Tax (Line 6 + Line 7)
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9. Amount Subject to Use Tax $ ________________________
Times 3.0% of that (x 0.03)
10. If Return is filed or Total Tax is paid after Due Date, add Penalty + Interest:
A. Penalty: 10% (0.10) of Lines 8 + 9 .
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B. Interest: 1% (0.01) of Lines 8 + 9 per month or any portion
Total Penalty & Interest
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11. Total Tax, Penalty & Interest (Lines 8 + 9 + "Total Penalty & Interest") .
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12. Add: Underpayment on Prior Return
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13. Deduct: Overpayment on Prior Return
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14. Total Due and Payable (Lines 11 + 12 - Line 13)
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(Please make check or money order payable to "City of Sterling.")
New business name, address, phone number, and/or owner:
_____
Check here for permanent business closure.
_____
Check here for change of address.
_____
Check here for change of ownership.
____________________________
Date of change:
I certify under penalty of perjury that the statements made hereon are to the best of my knowledge true and correct.
Signature:
Phone:
Company:
Date:
WHITE COPY: Return to Finance Department.
YELLOW COPY: Keep for your records.
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