Sales/use Tax Return Form
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1CITY OF SHERIDAN,COLORADO SALES/USE TAX RETURN
TAXPAYER'S NAME AND ADDRESS
PERIOD:
DUE DATE:
LICENSE #:
1.
GROSS SALES AND SERVICE
5A.
AMOUNT OF CITY SALES TAX DUE (Line 4 x 3.5%)
N/A
2A. ADD: BAD DEBTS COLLECTED
5B.
NOT APPLICABLE
2B. TOTAL LINES 1 AND 2A
6.
ADD: EXCESS TAX COLLECTED:
NON-TAXABLE SERVICE
3.
A.
7.
ADJUSTED SALES TAX COLLECTED:
SALES
(ADD LINES 5A, 5B & 6)
SALES TO OTHER LICENSED
B.
N/A
8.
DEALERS FOR RESALE
VENDOR FEE: NOT APPLICABLE
SALES SHIPPED OUT OF
C.
9.
AREA
TOTAL SALES TAX (LINE 7 MINUS LINE 8)
D.
BAD DEBTS CHARGED OFF
10.
NET TAXABLE USE TAX (FROM SCHEDULE B)
TRADE-INS FOR TAXABLE
E.
11.
USE TAX DUE (LINE 10 X 3.5%)
RESALE
SALES OF GASOLINE AND
F.
11 A.
TOTAL SALES AND USE TAX DUE (ADD LINES 9 AND 11)
CIGARETTES
SALES TO GOV'T, RELIGIOUS, AND
G.
IF FILING LATE
CHARITABLE ORGANIZATIONS
(A) PENALTY - GREATER OF $15 OR 15% ON TAX DUE
12.
AFTER DUE DATE
THEN ADD:
H.
RETURNED GOODS
(B) INTEREST - 1.5% PER MONTH ON TAX DUE
PRESCRIPTION DRUGS/THERAPEUTIC
TOTAL TAX, PENALTY, AND INTEREST DUE
I.
13.
DEVICES
(ADD LINES 11A AND 12)
J.
GROCERY (FOR HOME-CONSUMPTION ONLY)
A. ADD: (PRIOR PERIOD ADJUSTMENT)
14.
K.
FEDERAL FOOD STAMPS
B. DEDUCT: (PRIOR PERIOD ADJUSTMENT)
L.
OTHER DEDUCTIONS (LIST)
MAKE CHECK OR MONEY ORDER PAYABLE
TOTAL DUE AND
15.
TO CITY OF SHERIDAN
PAYABLE
(ADD LINES 13,14A & 14B)
3.TOTAL DEDUCTIONS
(TOTAL OF LINES 3 A-L)
AMOUNT PAID:
4. TOTAL CITY NET TAXABLE SALES & SERVICE
( 2B MINUS 3)
SCHEDULE A - SPECIAL MESSAGE FROM/TO CITY
SCHEDULE B - CITY USE TAX
SCHEDULE C - CONSOLIDATED ACCOUNTS
This schedule is required in all cases in which the taxpayer makes a consolidated
The use tax ordinance imposes a tax upon the privledge of using, storing, distributing or
return which includes sales made at more than one location. It must be completely
otherwise consuming in the City tangible personal property or taxable services
filled out and convey all information required in accordance with the column headings.
purchased, rented or leased.
If additional space is needed attach schedule in same format. Consolidated accounts
PERIOD'S TOTAL GROSS
PERIOD'S NET TAXABLE
NAME AND ADDRESS OF VENDOR
LICENSE NUMBER
BUSINESS ADDRESS
SALES
SALES
DATE OF PURCHASE
TYPE OF COMMODITY PURCHASED
PURCHASE PRICE
(A) LIST OF PURCHASES (IF ADDITIONAL SPACE NEEDED - ATTACH SCHEDULE IN SAME FORMAT
LINE 1
LINE 4
ENTER TOTAL HERE AND ON THE RETURN ABOVE
(B) TOTAL PURCHASE PRICE OF PROPERTY SUBJECT TO CITY USE TAX - ENTER TOTAL
LINE (B) ON LINE 10 ON TOP OF RETURN
I HEREBY CERTIFY UNDER PENALTY OF PERJURY, THAT THE STATEMENTS
NEW BUSINESS DATE:
CHANGE OF BUSINESS ADDRESS
MADE HEREIN ARE TO THE BEST OF MY KNOWLEDGE, TRUE AND
CORRECT.
MONTH
DAY
YEAR
CHANGE OF MAILING ADDRESS
X
SIGN
HERE
DISCONTINUED DATE:
PRINTED NAME
MONTH
DAY
YEAR
TITLE
DATE
PHONE
PLEASE REMIT TO: CITY OF SHERIDAN, 4101 So. Federal Blvd., Sheridan, CO 80110-5399
FOR QUESTIONS, PLEASE VISIT OUR WEBSITE AT OR CALL (303) 762-2200 EXT. 308
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