Combined Excise Tax Return Form - August 2001 Page 4
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5Line 15 – Retailing (B&O)
I.D.
Amount
Line 47 – Power
I.D.
Amount
Bad Debts
0201
Bad Debts
4901
Cash & Trade Discounts
0202
Cash & Trade Discounts
4902
Interstate & Foreign Sales
0204
Interstate & Foreign Sales
4904
Motor Vehicle Fuel Tax
0205
4939
Amounts Paid to Another for Services Jointly Provided
Advances Reimbursements; Rtrns & Allowances
0207
Amounts Expend. to Improve Consumer Efficiency
4942
No Local Activity
0208
Low Density/Wholesale Power Costs
4947
Casual Sales; Accommodation Sales
0213
Other (Explain):
4999
Tax in Gross
0214
TOTAL
Consignment Sales
0215
Line 48 - Gas Distribution; Telegraph
I.D.
Amount
Artistic/Cultural Activities
0216
2601
Bad Debts
Presc. Drugs Sold by Pub. Oper/Nonprofit Hospitals
0217
Cash & Trade Discounts
2602
Other (Explain):
0299
Interstate & Foreign Sales
2604
TOTAL
2639
Amounts Paid to Another for Services Jointly Provided
Not all deductions are allowable from both
Other (Explain):
2699
Retailing (B&O Tax) and Retail Sales Tax.
TOTAL
Line 16 - Retail Sales Tax
I.D.
Amount
Line 49 - Motor Transportation; Railroad…
I.D.
Amount
Bad Debts
0101
Bad Debts
0801
Cash & Trade Discounts
0102
Cash & Trade Discounts
0802
Interstate & Foreign Sales
0104
Interstate & Foreign Sales
0804
Tax in Gross
0114
Amounts Paid to Another for Services Jointly Provided
0839
Sales to U.S. Government
0118
Other (Explain):
0899
Motor Vehicle Fuel Sales
0119
TOTAL
Prescription Drugs/Hearing Aids/Lenses/etc
0121
Amount
Line 50 - Urban Transportation; Vessels…
I.D.
Exempt Food Sales
0122
Bad Debts
1201
Qualified Nonresident Sales
0123
Cash & Trade Discounts
1202
Trade-in Allowance
0124
Interstate & Foreign Sales
1204
Newspapers
0125
1239
Amounts Paid to Another for Services Jointly Provided
Certain Network Telephone Service
0126
Other (Explain):
1299
Sales to Indians with Delivery on the Reservation
0128
TOTAL
Sales of Feed to Fish Farmers
0129
Line 51 - Other Public Service Business
I.D.
Amount
Taxable Amount for Tax Paid at Source
0130
Bad Debts
1301
Returns & Allowances
0131
Cash & Trade Discounts
1302
Sales to Nonprofit Artistic/Cultural Art Objects for
0132
Displays
Interstate & Foreign Sales
1304
Ride-Sharing Vans
0134
Amounts Paid to Another for Services Jointly Provided
1339
Purebred Livestock for Breeding
0135
Other (Explain):
1399
Tax Deferral/Investment Certificate No._________
0136
TOTAL
Sale of Manufacturing Mach/Equip; Install Labor
0156
Line 52 - Tobacco Products
I.D.
Amount
Other (Explain):
0199
Interstate & Foreign Sales
2004
TOTAL
Sales to U.S. Government
2018
Line 45 - Water Distribution
I.D.
Amount
Returned/Destroyed Goods
2043
Bad Debts
6001
Other (Explain):
2099
Cash & Trade Discounts
6002
TOTAL
Interstate & Foreign Sales
6004
Line 53 - Refuse Collection
I.D.
Amount
Amounts Paid to Another for Services Jointly Provided
6039
Amounts Received by Nonprofit Water Association
6401
Bad Debts
6040
for Capital Projects
Sales to U.S. Government
6418
Amounts Derived From Distribution of Water
6041
Through Irrigation Systems
Sales to Other Refuse/Solid Waste Collectors
6445
Conservation Expenditures
6057
Other (Explain):
6499
Reclaimed Water
6058
TOTAL
Other (Explain):
6099
Line 54 - Petroleum Tax
I.D.
Amount
TOTAL
Petroleum Products Exported Out of State
5746
Line 46 - Sewer Collection
I.D.
Amount
Other (Explain):
5799
Bad Debts
6101
TOTAL
Cash & Trade Discounts
6102
Line 55 - Hazardous Substance
I.D.
Amount
Amounts Paid to Another for Services Jointly Provided
6139
Other (Explain):
6599
Other (Explain):
6199
TOTAL
TOTAL
REV 40 2406 AUG/01 (5-25-01)
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