Form A-14 - Business & Occupation Activities Return - 2014
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5January - December 2014
A
14
Business & Occupation Activities Return
Mail to:
State of Washington
Department of Revenue
PO Box 47464
Tax Registration Number
Olympia, WA 98504-7464
Name
Use Black Ink &
4
Business Name
Return Original Form.
Street Address
Only fill in the
4
City, State, Zip
classifications you qualify
for.
Has Your Address Changed?
No Business Activity?
Business Closed?
Please check appropriate box(es) below and note changes on address above.
If you had no business activity and did not file by
Check this box and enter date closed.
telephone, check this box, sign and mail us your return.
Effective date of change
File by telephone: Call 1-800-647-7706. At the greeting,
Business Location Change
Mailing Address Change
enter code 111 to start the process.
Other Correspondence?
I. State Business and Occupation (B&O) Tax
1.
Travel Agent Comm/Tour Operator; Intl Charter Freight Brokers; Stevedoring; Assisted Living Facilities [28]
Gross Amount
Taxable Amount
Tax Due
Deductions*
Rate
.
,
,
.
,
.
,
,
.
,
,
X
-
=
.00275
Insurance Producers; Title Insurance Agents; Surplus Line Broker Commissions [14]
2.
Gross Amount
Taxable Amount
Tax Due
Deductions*
Rate
.
,
.
,
,
,
,
.
,
.
,
X
-
=
.00484
3.
Royalties; Child Care [80]
Gross Amount
Taxable Amount
Tax Due
Deductions*
Rate
.
.
,
,
.
,
.
,
,
,
,
X
-
=
.00484
4.
Wholesaling [03]
Gross Amount
Taxable Amount
Tax Due
Deductions*
Rate
,
.
,
,
.
,
,
.
,
,
.
X
-
=
.00484
5.
For Profit Hospitals; Scientific R&D [135]
Gross Amount
Deductions*
Taxable Amount
Rate
Tax Due
.
,
.
,
.
,
,
,
.
,
,
X
-
=
.015
6.
Service & Other Activities [04]
Gross Amount
Taxable Amount
Tax Due
Deductions*
Rate
.
,
.
,
.
,
,
,
,
.
,
X
-
=
.015
*
Deductions taken but not itemized on pages 3 & 4 will be disallowed.
State and Local Use Tax/Deferred Sales Tax (See page 2.)
4
DUE DATE: January 31, 2015
IV. Totals
* 5% Penalty Assessed After February 02, 2015
,
,
.
15% Penalty Assessed After March 02, 2015
18. Total Tax Due from Section I
25% Penalty Assessed After March 31, 2015
(Tax due from lines 1-6)
If the due date falls on a weekend or legal holiday,
,
,
.
19. Total Tax Due from Section II
the due date is extended to the next business day.
(Tax due from line 12)
Filing an Amended Return?
20. Total All Addendums
,
,
(Example:
.
Local Sales/Use Tax)
Check this box and attach amended return
information and a letter of explanation.
,
,
.
Penalty waiver request?
21. Subtotal
(add lines 18-20)
Check this box and attach a letter of explanation.
,
,
.
4
22. Total Credit from Section III
Make check or money order payable to the Washington State Department
of Revenue.
(from page 2, line 17)
4
Please write your tax registration number on your check.
,
,
.
23. Subtotal
(subtract line 22
4
Signature
from line 21)
4
,
Print Name
,
.
24. * Add Penalty,
if Applicable
(Minimum $5.00)
%
(
)
/
/
4
Phone Number
Date
,
,
.
Total Amount Due
25.
Internet/Fax
(10-28-14)
Page
1
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