Form 15 - Wyoming Contractor Use Tax Return - 2011
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1Department of Revenue
Department of Revenue
Department of Revenue
Department of Revenue
Department of Revenue
Wyoming Contractor Use Tax Return
Herschler Bldg., 122 W. 25th St.
Herschler Bldg., 122 W. 25th St.
Herschler Bldg., 122 W. 25th St.
Herschler Bldg., 122 W. 25th St.
Herschler Bldg., 122 W. 25th St.
Cheyenne, WY
Cheyenne, WY
Cheyenne, WY
Cheyenne, WY
Cheyenne, WY
82002-0110
82002-0110
82002-0110
82002-0110
82002-0110
Form 15
Form 15
Form 15
Form 15
Form 15
Department
Use ONLY
This Tax Return MUST BE POSTMARKED
RID:
Ownership
on or before the following date to
Name:
avoid late penalty and interest:
PLEASE COMPLETE THIS FORM BY
Report Period:
through
Feb 01, 1996
Feb 29, 1996
HAND - USE BLACK INK ONLY
MO
DAY
YR
MO
DAY
YR
1.
Gross purchases
2.
Total deductions
3.
Net taxable purchases
Please write neatly inside the boxes!
Please write neatly inside the boxes!
4. Use Tax Due This Report Period:
Use Tax Due
Use Tax Due
Material/Supply Cost
Material/Supply Cost
Material/Supply Cost
Material/Supply Cost
Material/Supply Cost
Use Tax Due
Use Tax Due
Use Tax Due
Use Tax Due
Use Tax Due
Use Tax Due
Use Tax Due
Use Tax Due
Material/Supply Cost
Material/Supply Cost
Material/Supply Cost
Material/Supply Cost
Material/Supply Cost
= = = = =
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
= = = = =
X X X X X
X X X X X
02 0 12345
County
County
County
County
County
4A.
4A.
4A.
County
County
County
County
County
4A.
4A.
4B.
4B.
4A.
4A.
4B.
4B.
4B.
4B.
4B.
4A.
4A.
4A.
4B.
4B.
4B.
4D.
4D.
4D.
4D.
4D.
4C.
4C.
4C.
4C.
4C.
4C.
4C.
4C.
4C.
4C.
4D.
4D.
4D.
4D.
4D.
5 %
6 %
Natrona
Albany
6 %
5 %
Niobrara
Big Horn
4 %
5 %
Park
Campbell
6 %
6 %
Platte
Carbon
6 %
5 %
Sheridan
Converse
4 %
6 %
Sublette
Crook
6 %
4 %
Sweetwater
Fremont
6 %
5.25%
Teton
Goshen
5 %
5 %
Uinta
Hot Springs
6 %
5 %
Washakie
Johnson
5 %
6 %
Weston
Laramie
5 %
4E. Total USE tax due
4E. Total USE tax due
4E. Total USE tax due
4E. Total USE tax due
4E. Total USE tax due
Lincoln
(Columns 4D):
(Columns 4D):
(Columns 4D):
(Columns 4D):
(Columns 4D):
5. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (This Line is not used) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
6. Additional Tax Due ......................................................................................................................
7.
Please Reference
Project Number(s):
8.
(From Line 4E)
(From Line 4E)
9. TOTAL TAX DUE
(From Line 4E)
(From Line 4E)
(From Line 4E)
10. Adjustments
(Mark one:
P & I
OR
CREDIT)
11.
TOTAL DUE
TOTAL DUE
TOTAL DUE
( ( ( ( (
) ) ) ) )
TOTAL DUE
TOTAL DUE
Lines 9 + 10
Lines 9 + 10
Lines 9 + 10
Lines 9 + 10
Lines 9 + 10
PAY THIS AMOUNT
PAY THIS AMOUNT
PAY THIS AMOUNT
PAY THIS AMOUNT
PAY THIS AMOUNT
,
.
,
TO AVOID PENALTY AND INTEREST YOU MUST PAY THE TAX BY THE END OF THE MONTH FOLLOWING THE MONTH OF PURCHASE .
F F F
I declare, under penalty of perjury, that I have examined this return and to the best of my knowledge and belief it is correct and complete.
Rev. 4/01/11
Eff. 4/01/11
Authorized
Signature
Title
FEIN/SSN
Date:
/
/
Phone No. (
)
-
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