Iowa Regular Local Option Tax And School Local Option Tax Form 2004 Page 2
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1
2Check here to cancel your
permit and enter the last date
of making taxable purchases:
______________________
Check here to change your
filing frequency. Enter the
filing frequency you are
changing to and the effective
date:
Permits cannot be transferred
Permits cannot be transferred from one owner to another or from one type of business to
______________________
another, for example, when changing from a sole proprietorship to a corporation. The prior
owner must cancel his/her permit and the new owner must apply for a new permit.
Check here if you want
information on paying tax
electronically (EFT filing).
32-004 rf17b 10/02
IOWA REGULAR LOCAL OPTION TAX AND SCHOOL LOCAL OPTION TAX
effective January 1, 2004, through June 30, 2004
Taxable Purchases Taxable Purchases
Taxable Purchases Taxable Purchases
Taxable Purchases Taxable Purchases
LocalOption
School
LocalOption
School
Local Option
School
PAGE
73
.00
.00
ADAIR
01
.00
.00
GREENE
37
.00
.00
GRUNDY
38
.00
.00
PALO ALTO
74
.00
.00
ADAMS
02
.00
.00
PLYMOUTH
75
.00
.00
ALLAMAKEE
03
.00
.00
GUTHRIE
39
.00
.00
POCAHONTAS
76
.00
.00
APPANOOSE
04
.00
.00
HAMILTON
40
.00
.00
AUDUBON
05
.00
.00
HANCOCK
41
.00
.00
POLK
77
.00
.00
HARDIN
42
.00
.00
POTTAWATTAMIE78
.00
.00
BENTON
06
.00
.00
POWESHIEK
79
.00
.00
BLACK HAWK
07
.00
.00
HARRISON
43
.00
.00
RINGGOLD
80
.00
.00
BOONE
08
.00
.00
HENRY
44
.00
.00
SAC
81
.00
.00
BREMER
09
.00
.00
HOWARD
45
.00
.00
BUCHANAN
10
.00
.00
HUMBOLDT
46
.00
.00
SCOTT
82
.00
.00
SHELBY
83
.00
.00
BUENA VISTA
11
.00
.00
IDA
47
.00
.00
SIOUX
84
.00
.00
BUTLER
12
.00
.00
IOWA
48
.00
.00
STORY
85
.00
.00
CALHOUN
13
.00
.00
JACKSON
49
.00
.00
.00
JASPER
50
.00
.00
TAMA
86
.00
.00
CARROLL
14
.00
.00
TAYLOR
87
.00
.00
CASS
15
.00
.00
JEFFERSON
51
.00
.00
.00
UNION
88
.00
.00
CEDAR
16
.00
.00
JOHNSON
52
.00
.00
VAN BUREN
89
.00
.00
CERRO GORDO
17
.00
.00
JONES
53
.00
.00
KEOKUK
54
.00
.00
WAPELLO
90
.00
.00
CHEROKEE
18
.00
.00
WARREN
91
.00
.00
CHICKASAW
19
.00
.00
KOSSUTH
55
.00
.00
WASHINGTON
92
.00
.00
CLARKE
20
.00
.00
LEE
56
.00
.00
WAYNE
93
.00
.00
CLAY
21
.00
.00
LINN
57
.00
.00
See below.
CLAYTON
22
.00
.00
LOUISA
58
.00
.00
WEBSTER
94
Webster is the only county with a rate of 1/2% for each tax.
LUCAS
59
.00
.00
WINNEBAGO
95
.00
.00
CLINTON
23
.00
.00
WINNESHIEK
96
.00
.00
CRAWFORD
24
.00
.00
LYON
60
.00
.00
.00
WOODBURY
97
.00
.00
DALLAS
25
.00
.00
MADISON
61
.00
.00
MAHASKA
62
.00
.00
WORTH
98
.00
.00
DAVIS
26
.00
.00
WRIGHT
99
.00
.00
DECATUR
27
.00
.00
MARION
63
.00
.00
TOTAL TAXABLE
DELAWARE
28
.00
.00
MARSHALL
64
.00
.00
PURCHASES
.00
.00
DES MOINES
29
.00
.00
MILLS
65
.00
.00
MULTIPLY BY .01
.00A
.00B
DICKINSON
30
.00
.00
MITCHELL
66
.00
.00
WEBSTER CO.
94
DUBUQUE
31
.00
.00
MONONA
67
.00
.00
TOTAL TAXABLE
PURCHASES
.00
.00
EMMET
32
.00
.00
MONROE
68
.00
.00
MULTIPLY BY .005 .00C
.00D
FAYETTE
33
.00
.00
MONTGOMERY
69
.00
.00
ADD A & C
ADD B & D
TOTAL TAX
.00
.00
FLOYD
34
.00
.00
MUSCATINE
70
.00
.00
ENTER ON FRONT
ENTER ON FRONT
O’BRIEN
71
.00
.00
FRANKLIN
35
.00
.00
OF RETURN, LINE 3
OF RETURN, LINE 4
.00
FREMONT
36
.00
.00
OSCEOLA
72
.00
.00
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