Business Tax Act / License And Tax Report Form - Thompson'S Station, Tn Page 2

C. Sales Tax Rports

1

Gross Taxable Sales for Tax Purposes to the State of Tennesse………………………………………………………………………………………………………………………………

2

Total Amout of Deductions for State Sales Tax for Tax Period (from Schedule A on the State Tax Return)…………………………………………………………………………………

3

Total Amount of Sales tax Due State for Period (Line 14 State Tax Return) …..………………………...…………………………………………………..……….……..…………………

The amounts reflected above should equal the total of thes items on all State Sales and Use Tax Returns for the tax period, including any montly returns which may be deliquent

Schedule A. Deductions for Business Tax Purposes

Sales of Services substantially performed in other States

1.

2.

The proceeds of the sale of goods, wares, or merchandise returned by the customer when the sales price is refunded either in cash or in credit. Line E, Schedule A, State Sales

Tax Return

Bona Fide Sales in Interstate Commerce where the purchaser takes possession outside of Tennessee for use or consumption outside of Tennessee and item is actually delivered by

3.

the seller of common carrier.

4.

Cash discounts allowed and taken on sales. Line J, Schedule A, State Sales Tax Return

Repossessions--Enter that portion of the unpaid principal balances in excess of $500.00 due on tangible personal properties repossessed from customers. (Line H, Schedule A,

5.

State Sales Tax Return.)

6.

The amounts allowed at trade-in value for any article sold

7.

Amounts subcontracted to other persons for additions or improvements to real property. Attach list of subcontractors and addresses, items subcontracted and amounts.

Federal excise taxes and state privilge and excise taxes on the following items (indicate amounts sold and deductions)

8.

Gasoline and Motor Fuel Tax:

a. Gasoline Tax Paid: ……………………………………………………………………………………………………

Federal

State

Totals

.............................................................................................................................................................................................................................

b. Motor Fuel Use Tax Paid: ……………………………………………………………………………………….

Federal

State

Totals

.............................................................................................................................................................................................................................

c. State Special Tax on pertroleum products:

..........................................................................................................................................................................................................................................................

d. Liquefied Gas for motor vehicles:

................................................................................................................................................................................................................................................................

9.

TOBACCO TAX

a. Cigarettes:

................................................................................................................................................................................................................................................................

Federal

State

Totals

.............................................................................................................................................................................................................................

b. Other Tobacco Products: ………………………………………………………….

Federal

State

Totals

.............................................................................................................................................................................................................................

10. BEER

Federal

a. Beer:

State

b. 17% of Wholesaler's Cost per beer sold: ……….

...........................................................................

.............................................................................................................................................................................................................................

Totals

11.

OTHER (specify)

Part A

12

Total Deductions. Enter here and in line B2 , Page 1

..................................................................................................................................................................................................................

(Note: All deductions must have adequate records maintained to subtanitate deductions claimed, otherwise they will be disallowed)

Persons with two or more busines in a city and or county may, upon request opain forms an file with the apporpriate officer consolidated tax returns provided only, however, that such business are taxable under the same

classification and at the rate . Consolidated returns must contain a schedule, by individual locations giving nescessary infromation to determine tax liablility at each location.

Returns Filed For More Than One Location

If return is filed for more than one location, list address and amount of Gross Sales of each. All such business must be taxable under the same classification and at at the same rate

Street, Address, City, State, Zip

Gross Sales

Deductions

0

-

-

-

-

I certify that this return, including any accompanying schedule or statements, has been examined by me and is to the best of my knowledge and belief a true and complete return , made in good faith, for the tax period stated pursuant in the

provisions of Chapter 58 Title 67, Tennessee Code Annotated, known as the Business Tax Act. If prepared by any one other than the tax payer , this return is based upon all information which I have any knowledge , under pentalties provided by

the return Preparer Act of 1969.

This return is for the tax period from

to

Signature of Individual, member of firm, or officer or corporation

Date

Signature of preparer, including title if employee of the taxpayer. If person preparing return is not an employee of the taxpayer, state name of Attorney, CPA or PA and signature of employee

Date

preparing return.