Form 32-003 Rf43a - Iowa Retailer'S Use Tax Annual Return

Form 32-003 Rf43a - Iowa Retailer'S Use Tax Annual Return - 2002

Information Form

Use this form to report address and name changes, cancel your permit, change

your filing frequency, or request information on Electronic Funds Transfer (EFT).

Permit number

Enter weekday phone number

Location name and address

Mailing name and address

If different than above:

Correct location name and address (not a PO Box):

Correct mailing name and address:

Mail corrections,

cancellation or changes to:

Registration Services

PO Box 10465

Des Moines IA 50306-0465

If you had no sales in Iowa this year, put zeroes on lines 1 and

IOWA RETAILER'S USE TAX ANNUAL RETURN

12.

32-003 RF43A 11/19/02

1 Gross Sales in Iowa

2 Goods Consumed in Iowa

3 Total (add lines 1 and 2)

4 Exemptions (from line 21)

5 Taxable Amount (line 3 minus line 4)

Permit No.

Period

Date Due

6a State Tax (5% of line 5)

6b Total Local Option Tax

6c Total School Local Option Tax

7 Total Tax (add lines 6a, 6b, and 6c)

8 Deposits and Overpayment Credits

9 Balance (line 7 minus line 8)

10 Penalty (if applicable)

11 Interest (if applicable, see instructions)

Date

Title

Signature of Retailer or Agent

12 Total Amount Due (add lines 9-11)

Daytime Phone No.: ________________

Form 32-003 Rf43a - Iowa Retailer'S Use Tax Annual Return - 2002