Form Bt-136 - Oklahoma Telephone Access Line Surcharge Report 2009
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1
2STT
9100100
Oklahoma Telephone Access Line Surcharge Report
Total Access Lines
STT0001-11-02-BT
Taxpayer Copy/Worksheet
BT-136 Revised 12-09
1.
Total Number of
Access Lines . . . . . . . . . . .
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
–
2.
Exempt Access Lines . .
3.
Total Number of Access
=
Lines Subject to
Account Number: _____________________________________
Surcharge . . . . . . . . . . .
Dollars
Cents
4.
Amount Due
(Line 3 x $0.05) . . . . . . . . .
+
5.
Interest . . . . . . . . . . . . .
D. Change
E. Out of
+
6.
Penalty . . . . . . . . . . . . .
Business
Use this worksheet for figuring your surcharge, then enter the figures on the
=
7.
TOTAL DUE . . . . . . . . .
original report below.
Instructions for Completing Oklahoma Telephone Access Line Surcharge Report
LINE 1. (Total Number of Access Lines) –
General Instructions
LINE 6. (Penalty) – If this tax report and remit-
Enter the total number of access lines serviced
tance is not postmarked within 15 days of the
Please write only in the white areas.
by you for this reporting period.
due date, a one-time 10% penalty is due. Multiply
the tax amount on Line 4 by .10 to determine the
If any preprinted information on the report is
LINE 2. (Total Exempt Access Lines) – Enter
penalty.
incorrect, place an “X” in Box D and enter the
the total amount of exempt lines you are
correct information on back of the form in the
reporting for this period. All certificates, receipts
LINE 7. (Total Due) – Total the report. Add lines
space provided.
and/or invoices verifying each exemption must
4, 5 and 6.
be kept on file.
Please use a #2 pencil or pen with black ink to
Sign, date and detach the original report at the
mark your entries on this form. If you type your
LINE 3. (Net number of access lines subject
perforation and mail with your payment in the
report, please type “XXX” over “000” in Box
to surcharge) – Subtract Line 2 from Line 1 to
enclosed return envelope to:
F, at the top of the report. Use the small box
arrive at number of lines.
immediately after “Total Number of Access
Oklahoma Tax Commission
LINE 4. (Amount Due) – Multiply Line 3 by the
Lines” (Line 1) to align your typewriter for
Post Office Box 26850
tax rate shown.
typing the numbers in the handprint boxes of
Oklahoma City, OK 73126-0850
the report.
LINE 5, (Interest) – If this report and remittance
is postmarked after the due date shown on
Specific Instructions
Item C, the tax is subject to 1.25% interest per
If final report and out of business, place an “X”
month from the due date (Item C) until it is paid.
in Box E.
Multiply the amount on Line 4 by .0125 for each
Instructions continued on back...
month or part thereof that the report is late.
1 2 3 4 5 6 7 8 9 0 X
Special Note: To insure that your report will be properly
processed, please print all figures within boxes as shown.
Write only in white areas
Do not fold staple or paper clip
Please Detach Here and Return Report Below
STT0001-11-02-BT
F.
9100100
000
STT
Oklahoma Telephone Access Line Surcharge Report
Total Access Lines
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
1.
Total Number of
Access Lines . . . . . . . . . . .
–
2.
Exempt Access Lines . .
3.
Total Number of Access
f.c.
p.t.
– office use only –
D. Change E. Out of Business
=
Lines Subject to
Surcharge . . . . . . . . . . .
Account Number: ____________________________________
Dollars
Cents
4.
Amount Due
(Line 3 x $0.05) . . . . . . . . .
+
5.
Interest . . . . . . . . . . . . .
+
6.
Penalty . . . . . . . . . . . . .
=
7.
TOTAL DUE . . . . . . . . .
I declare that the information contained in this document and any attachments is true and correct to the best
of my knowledge and belief.
Sign
Here:
Date
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