Iowa Regular Local Option Tax And School Local Option Tax Form 2004 printable pdf download

Iowa Regular Local Option Tax And School Local Option Tax Form 2004

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,

Cancellations or

Changes to:

Registration Services

PO Box 10465

Des Moines IA 50306-0465.

IMPORTANT: You must file even if you had no activity. If you

IOWA CONSUMER’S USE TAX RETURN

had no tax to report, put zeroes in lines 1-8.

32-004 rf17a 10/02

1 Total Taxable Purchases (quarter)

Permit No.

Period

2 Consumer’s Use Tax (5% of line 1)

Date Due

Total Local Option Tax

You must complete the back side of this return.

Total School Local Option Tax

You must complete the back side of this return.

5 Total Tax (add lines 2, 3 and 4)

6 Penalty (if applicable)

7 Interest (if applicable)

8 Total Amount Due (add lines 5-7)

Date

Title

Signature

Daytime Phone No.: ________________

Iowa Regular Local Option Tax And School Local Option Tax Form 2004