Form 17 - Wyoming Sales/use Tax Return - 2011
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1Department of Revenue
Department of Revenue
Department of Revenue
Department of Revenue
Department of Revenue
Wyoming Sales/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
(Includes Resort Tax)
(Includes Resort Tax)
(Includes Resort Tax)
(Includes Resort Tax)
(Includes Resort Tax)
Form 17
Form 17
Form 17
Form 17
Form 17
Department
Use ONLY
This Tax Return MUST BE POSTMARKED
Ownership
Ownership
on or before the last day of the month
RID:
Name:
following the date of sale:
PLEASE COMPLETE THIS FORM BY
Report Period:
through
Feb 01, 1996
Feb 29, 1996
HAND - USE BLACK INK ONLY
1. Gross sales and services
2.
Total deductions
3. Net taxable sales
( Line 1 minus Line 2)
4. 4. 4. 4. 4.
Sales Tax Collected This Report Period:
Please write neatly inside the boxes!
Please write neatly inside the boxes!
Amount Subject to Tax
Amount Subject to Tax
Amount Subject to Tax
Tax Due
Tax Due
Tax Due
Tax Due
Tax Due
Amount Subject to Tax
Amount Subject to Tax
Amount Subject to Tax
Amount Subject to Tax
Amount Subject to Tax
Amount Subject to Tax
Amount Subject to Tax
Tax Due
Tax Due
Tax Due
Tax Due
Tax Due
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
Tax Rate
= = = = =
= = = = =
County
County
County
County
County
X
4A.
4A.
4A.
X
County
County
County
County
County
4A.
4A.
4B.
4B.
4B.
4B.
4B.
4A.
4A.
4A.
4A.
4A.
4B.
4B.
4B.
4B.
4B.
4D.
4D.
4D.
4D.
4D.
4C.
4C.
4C.
4C.
4C.
4C.
4C.
4C.
4C.
4C.
4D.
4D.
4D.
4D.
4D.
6 %
5 %
Natrona
Albany
5 %
6 %
Niobrara
Big Horn
5 %
4 %
Park
Campbell
02 0 12345
6 %
6 %
Platte
Carbon
5 %
6 %
Sheridan
Converse
6 %
4 %
Sublette
Crook
4 %
6 %
Sweetwater
Fremont
5.25%
6 %
Teton
Goshen
5 %
5 %
Uinta
Hot Springs
5 %
6 %
Washakie
Johnson
6 %
5 %
Weston
Laramie
5 %
4E. Total sales tax due (Column 4D):
4E. Total sales tax due (Column 4D):
4E. Total sales tax due (Column 4D):
4E. Total sales tax due (Column 4D):
4E. Total sales tax due (Column 4D):
Lincoln
Excess Tax
Excess Tax
Excess Tax
Excess Tax
Excess Tax ...............................................................................................................................................
5.
Resort Lodging
Resort Lodging
Resort Lodging
Tax Rate
esort Lodging Tax Due
Resort Lodging
Resort Lodging
6.
x
% = R
Sales
Sales
Sales
Sales
Sales
Resort Sales
Resort Sales
Resort Sales
Resort Sales
Resort Sales
x Tax Rate
% = Resort Sales Tax Due
7.
Resort Use
Resort Use
8. Resort Use
Resort Use
Resort Use
x Tax Rate
% = Resort Use Tax Due
........................................................................................................
9. TOTAL TAX DUE (Lines 4E +5+6+7+8)
(Lines 4E +5+6+7+8)
(Lines 4E +5+6+7+8)
(Lines 4E +5+6+7+8)
(Lines 4E +5+6+7+8)
.............................................................................................................................................
10 . . . . . ADJUSTMENTS
PAY THIS AMOUNT
PAY THIS AMOUNT
PAY THIS AMOUNT
PAY THIS AMOUNT
PAY THIS AMOUNT
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
,
,
.
F F F
Rev. 4/01/11
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.
Authorized
Eff. 4/01/11
Signature
Title
Date:
/
/
Phone No. (
)
-
If your address has changed, x appropriate box:
Business Location
Mailing Address
Both
New Address:
Has you business permanently closed? Date effective__/__/___(License will be canceled)
Has there been a change in ownership? Date effective__/__/___(License will be canceled)
(For ownership change, please provide name(s) and address of new owner(s) below:
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