Form 32-004 Rf16 - Consumer'S Use Tax Return - 2002

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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:
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.
IOWA CONSUMER’S USE TAX RETURN
IMPORTANT: You must file even if you had no activity. If you
had no tax to report, put zeroes in lines 1-8.
32-004 rf16a 11/22/02
1 Total Taxable Purchases (quarter)
s
s
s
Permit No.
Period
2 Consumer’s Use Tax (5% of line 1)
s
Date Due
Total Local Option Tax
3
s
You must complete the back side of this return.
Total School Local Option Tax
4
s
You must complete the back side of this return.
5 Total Tax (add lines 2, 3 and 4)
6 Penalty (if applicable)
s
7 Interest (if applicable)
s
Date
8 Total Amount Due (add lines 5-7)
Signature
Title
s
Daytime Phone No.: ________________
IOWA CONSUMER’S USE TAX RETURN
IMPORTANT: You must file even if you had no activity. If you
had no tax to report, put zeroes in lines 1-8.
32-004 rf16a 11/22/02
1 Total Taxable Purchases (quarter)
s
s
s
Permit No.
Period
2 Consumer’s Use Tax (5% of line 1)
s
Date Due
Total Local Option Tax
3
s
You must complete the back side of this return.
Total School Local Option Tax
4
s
You must complete the back side of this return.
5 Total Tax (add lines 2, 3 and 4)
6 Penalty (if applicable)
s
7 Interest (if applicable)
s
8 Total Amount Due (add lines 5-7)
s
Date
Title
Signature
Daytime Phone No.: ________________

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