Utility Tax Return Form

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City of Bothell, Washington
st
18305 101
Ave. NE
Bothell, WA 98011
UTILITY TAX RETURN
For Period:
Submitted By:
1. Gross Revenue
2. Deductions
3. Taxable Revenue
4. Tax (line 3 x 6%)
5. Penalty
6. Total Tax Due
Filed By:
Date Filed:
Signature
Printed Name
Title

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