Combined Excise Tax Return Form - August 2001 (Page 5 of 5) in pdf

Combined Excise Tax Return Form - August 2001 Page 5

SUPPLEMENT FORM 40 2406

State of Washington

Use this form if space on page 1 FORM 40 2406 is not sufficient

Department of Revenue

Period

Year

PO Box 47476

2001

LOCAL CITY AND/OR COUNTY SALES AND USE TAX

Olympia WA 98504-7476

Name

Tax Reporting Account No.

If you have business activity in more than one location, use the space below to show

breakdown of income by city or county. Group sales tax and use tax separately.

SALES TAX [45]

USE TAX [46]

City or

Rate

Tax Due

City or

Rate

Tax Due

Taxable Amount

County

of Tax

City or County

County

of Tax

City or County

Code

$0.00

Total Same as Line 16, Col 3, Pg. 1

Add Total Sales Tax Due

Total Same as Line 17, Col 1, Pg. 1

Add Total Use Tax Due

To inquire about the availability of this form in an alternate format for the visually impaired, please call (360) 753-3217. Teletype (TTY) users

may call (800) 451-7985. You may also access tax information on our Internet home page at

REV 40 0015e (3-21-01)

Combined Excise Tax Return Form - August 2001 Page 5