Sales/use Tax Return Form - City Of Northglenn
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1CITY OF NORTHGLENN
Account # 99-
Due Date:
SALES/USE TAX RETURN
Period Covered:
Department of Finance
Business Name & Address
PO BOX 5305
Denver, CO 80217-5305
PH: 303-450-8729 FAX:303-450-8708
$0.00
Northglenn Sales Tax (Line 5 x 4.0%) =
1 Gross Sales & Service:
6
$0.00
Food for Home Consumption:
Amount Subject to Tax
$0.00
2 Add: Bad Debts Collected:
7
_________________________________________x 3.0%=
3 Total Lines 1 & 2:
$0.00
Admissions Subject to Tax:
$0.00
4 A. Non-Taxable Service Sales
8
_________________________________________x 3.0%=
B. Sales For Resale
9 Accommodations Subject to Tax:_____________x 5.0%=
$0.00
D C. Shipped Out of City/State
10 Bowling Subject to Tax:____________________ x 4.0% =
$0.00
E D. Bad Debts: City Sales Tax Paid
11 Excess Tax Collected
$0.00
D E. Trade-ins for Taxable Resale
12 Adjusted Tax: (Add Lines 6, 7, 8, 9, 10, and 11)
U F. Sales of Gas & Cigarettes
C G. Gov., Religious & Charitable
13
Vendors Fee: Deduct 1% of Line 12 (IF PAID BY DUE DATE)
$0.00
T H. Returned Goods
14 Total Sales Tax: (Line 12 minus Line 13)
I
I. Prescriptions, Prosthetic Devices
City Use Tax (Attach Schedule): Amount Subject to
$0.00
O J. Food for Home Consumption
O J. Food for Home Consumption
15
15 Tax_____________________________________ x 4.0%=
Tax_____________________________________ x 4.0%=
N K. Other Deductions: List Separately
$0.00
16 Total Tax Due:
( Add lines 14 & 15)
S L.
17 Penalty (if Filed After the Due Date): 15% of Line 16
Interest (if Filed After the Due Date): 0.50% per Month of
$0.00
TOTAL DEDUCTIONS:
18
Line 16
$0.00
NET TAXABLE SALES:
5
$0.00
19 Total Tax, Penalty, & Interest: (Add Lines 16, 17, 18)
$0.00
I hereby Certify under penalty of perjury, that the Statements made herein
Adjustment from Prior Period (Attach Copy of Assessment)
are to the best of my knowledge, true, & correct.
20
A. Add:
PRINT & SIGN IN BLUE OR BLACK INK
B. Deduct:
Signed:
TOTAL DUE & PAYABLE:
21
$0.00
Company:
Show Below Change of Ownership and/or Address, Phone, Etc.
Title:
Phone:
If Business Closed, please state so and include the closing Date:
_____Mailing Address
_____Business Address
BUSINESS TAX LICENSE IS NOT TRANSFERABLE
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Parent category: Financial