Amnesty Combined Sales And Use Tax Return Form

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NEVADA DEPARTMENT OF TAXATION
Permit No.:
AMNESTY COMBINED SALES AND USE TAX RETURN
For Department Use Only
Mail Original To:
Nevada Department of Taxation
1550 E. College Parkway
Suite 115
Carson City NV 89706
Business Name & Address
For Period Beginning:
Ending:
The rates on this return covers the period of
January 1, 2001 through June 30, 2002.
For Amnesty Use Only
A RETURN MUST BE FILED EVEN IF NO TAX LIABILITY EXISTS
ENTER AMOUNTS IN
TAXABLE
TAX
CALCULATED
AMOUNT SUBJECT
COUNTY OF SALES/USE
EXEMPTIONS
TOTAL SALES
(OR COUNTY OF
TO USE TAX
AMOUNT
RATE
TAX
DELIVERY)
TAX CALCULATION
COLUMN A
+ COLUMN B
- COLUMN C
= COLUMN D
X COLUMN E
= COLUMN F
FORMULA
7.000%
01 CHURCHILL
02 CLARK
7.250%
6.750%
03 DOUGLAS
6.500%
04 ELKO
6.500%
05 ESMERALDA
6.500%
06 EUREKA
07 HUMBOLDT
6.500%
6.500%
08 LANDER
6.500%
09 LINCOLN
6.500%
10 LYON
6.500%
11 MINERAL
12 NYE
6.750%
7.000%
13 CARSON CITY
6.500%
14 PERSHING
7.250%
15 STOREY
7.250%
16 WASHOE
17 WHITE PINE
6.875%
0.01
TOTALS
18.
I HEREBY CERTIFY THAT THIS RETURN INCLUDING ANY
18. TOTAL CALCULATED TAX (COLUMN F)
ACCOMPANYING SCHEDULE AND STATEMENTS HAS BEEN EXAMINED
BY ME AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IS A TRUE,
19.
19. ENTER COLLECTION ALLOWANCE (1.25% OF LINE 18)
CORRECT AND COMPLETE RETURN.
20.
RETURN MUST BE SIGNED
20. NET TAXES (LINE 18 MINUS LINE 19)
Amnesty
21.
21. PENALTY (10% OF LINE 20)-WILL ACCRUE AFTER JUNE 30, 2002
___________________________________________________________
SIGNATURE OF TAXPAYER OR AUTH. AGENT
Amnesty
22.
22. INTEREST WILL ACCRUE AFTER JUNE 30, 2002-see instructions
___________________________________________________________
23.
23. PLUS LIABILITIES ESTABLISHED BY THE DEPARTMENT
TITLE
PHONE NUMBER (WITH AREA CODE)
24.
24. LESS CREDIT(S) APPROVED BY THE DEPARTMENT
___________________________________________________________
FEDERAL TAX IDENT NO.
DATE
25.
25. TOTAL AMOUNT DUE AND PAYABLE
26.
26. TOTAL AMOUNT REMITTED WITH RETURN
MAKE CHECKS PAYABLE TO NEVADA DEPARTMENT OF TAXATION
SALES/USE TAX RETURN
AMNESTY 01-01/06-02
Revised 1-4-02

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