Combined Excise Tax Return Form - Oct - Nov - Dec 2001 Page 2

ADVERTISEMENT

IV LODGING TAXES
TRANSIENT RENTAL INCOME INFORMATION
(enter location code and income only)
Code 47
Line
Location Code
Income
Location Code
Income
Location Code
Income
No.
37
38
CONVENTION AND TRADE CENTER TAX
SPECIAL HOTEL/MOTEL TAX
Code 48
Code 70
Line
Line
Taxable Amount
Rate
Tax Due
Location Code
Taxable Amount
Rate
Tax Due
Location Code
No.
No.
39
42
40
43
41
44
TOTAL CONVENTION & TRADE CENTER TAX
TOTAL SPECIAL HOTEL/MOTEL TAX
V STATE PUBLIC UTILITY TAX
Line
Column I
Col. 2 Deductions*
Column 3**
Col. 4
Column 5
Tax Classification
Code
No.
Gross Amount
Totals from Pg. 4
Taxable Amount
Rate
Tax Due
45
Water Distribution
60
.05029
46
Sewer Collection
61
.03852
47
Power
49
.03873
48
Gas Distribution; Telegraph
26
.03852
49
Motor Transportation; Railroad; Railroad Car
08
.01926
50
Urban Transportation; Vessels Under 65 ft
12
.00642
51
Other Public Service Business
13
.01926
** If taxable amounts on lines 45-51 column 3 total less than $6,000, no Public Utility Tax is due.
TOTAL STATE PUBLIC UTILITY TAX
VI OTHER TAXES
Line
Column I
Col. 2 Deductions*
Column 3
Col. 4
Column 5
No.
Tax Classification
Code
Gross Amount
Totals from Pg. 4
Taxable Amount
Rate
Tax Due
52
Tobacco Products
20
.7490
53
Refuse Collection
64
.036
54
Petroleum Tax
57
Temporarily Not Due - Fund Limit Reached
.005
55
Hazardous Substance
65
.007
Intermediate Care Facilities for the Mentally
56
79
.06
Retarded (IMR)
* Deductions taken but not itemized on page 4 will be disallowed.
Line
Tax Classification
Code
Item
Quantity Sold
Rate
Tax Due
No.
Number of Stoves, Fireplaces, & Solid Fuel
57
Solid Fuel Burning Device Fee
59
$30.00
Burning Devices:
58
Syrup Tax
54
Number of Gallons:
$1.00
59
State Enhanced 911 Tax
93
Number of Taxable Switched Access Lines:
.20
TOTAL OTHER TAXES
(add lines 52-59)
NOTE:
VII CREDITS
Line
Credit
1. If you do not have deductions, do not return pages 3 and 4.
Credit Classification
Amount
I.D.
No.
2. If you have deductions, complete and return pages 3 and 4.
60
800
Multiple Activities Tax Credit (attach Schedule C)
3. LOCAL CITY AND/OR COUNTY SALES AND USE TAX. For
High Technology Credit
your convenience, a copy of the Local City and/or County
61
830
(attach Research & Development Credit Affidavit)
Sales and Use Tax supplemental form is provided in the
Manufacturing Software; Programming Rural Employment B&O
“Business Tax Guide.” If more space is required, you may
62
860
Credit
make copies of this form or attach additional local tax
information in the same format.
63
865
Help Desk Services B&O Credit
4. For more information about the penalty waiver criteria, please
64
875
Alternatives to Field Burning B&O Credit
call Tax Express at (800) 334-8969, enter code 429.
65
855
International Services Credit
5. For more information about business closures, please call Tax
Express at (800) 334-8969, enter code 430.
66
815
Small Business B&O Tax Credit (see table enclosed)
6. If you would like to file “No Business Activity” by
Electric Utility Rural Economic Development Revolving Fund
67
870
telephone, please call our toll-free number (800) 647-7706
Public Utility Tax Credit
and do not mail return.
68
801
Bad Debt Tax Credit (attach Schedule B)
7. To inquire about the availability of this form in an alternate
69
805
format for the visually impaired, please call (360) 486-2342.
Hazardous Substance
Teletype (TTY) users may call (800) 451-7985.
Public Utility Tax Credit for Billing Discounts/Qualified Contributions
70
880
to a Low Income Home Energy Assistance Fund
8. Need Help? If you need further information, please refer to the
“Business Tax Guide”, or call the Department of Revenue office
71
810
Other Credits (attach appropriate documents)
nearest you, or call our toll-free number (800) 647-7706. You
TOTAL CREDIT (transfer to page 1, line 33)
may also access our Internet home page at
REV 40 2406 Q4/01 (10-09-01)
2
THIS FORM IS PRINTED ON RECYCLED PAPER

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 5