Form 21-1 - Oklahoma Consumer Use Tax Report - 2003
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1
2
3222
222
STU
4200500
If Report is typed or
STU0002-07-99-BT
machine printed
21-1
see instructions
Oklahoma Consumer Use Tax Report
Revised 10-2003
D. Permit Number
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
0 1
H. Page
of
Page(s)
Mailing
Business G. Out of Business
-Office Use Only-
F.C.
P.T.
F. Address Change
E. Mailing Address
_______________________________________________
Name
_______________________________________________
Address
_______________________________________________
City
State
ZIP
Dollars
Cents
1.
Purchase price of tangible personal property purchased outside and brought into Oklahoma
for own use or consumption. (Do not include transportation charges)................................................. 1.
2.
Total legal deductions (explain fully on reverse side)........................................................................... 2.
3.
Balance on which Use Tax is due (line 1 less line 2)............................................................................ 3.
4.
Amount of tax (4.5% of line 3).............................................................................................................. 4.
5.
Less: Sales and/or Use Tax previously paid to another state on property
included in line 3 (Cannot exceed 4.5% tax rate) ................................................................................ 5.
6.
Subtotal (Line 4 minus line 5) .............................................................................................................. 6.
7.
Interest 1.25% per month of line 6 from date delinquent to date of payment ....................................... 7.
8.
Penalty: 10% of line 6, if not paid within 15 days from due date ......................................................... 8.
9.
Subtotal ................................................................................................................................................ 9.
10. State Tax (from line 9) ......................................................................................................................... 10.
11. City/County Use Tax (sum of line(s) O. of column M from schedule below and supplement pages) ... 11.
12. Total State and City/County due (remit this amount) (Add lines 10 and 11) ........................................ 12.
Distribution of Tax for Cities/Counties
I.
J.
K.
L.
M.
N.
Interest
Net Taxable
City/County
City/County
and
Purchase
Total Due
City/County
Penalty
Code
Use Tax
1.
2.
3.
4.
O.
Total
Do Not Use This Form for Reporting Sales Tax
The Oklahoma Tax Commission is not required to give actual notice of changes in any State tax law.
I declare under the penalties of perjury, this return (including any accompanying schedules) has been examined by me, and to the best of my
knowledge and belief is a true , correct, and complete return.
Signature of Taxpayer
Date
Prepared by
Date
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