Form 21-3 - Oklahoma Vendors Use Tax Report

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STU
STU
4200700
4200700
222
222
222
222
STU
4200700
222
222
Q.
Q.
Q.
IF REPORT IS TYPED
IF REPORT IS TYPED
STU0002-11-02-BT
STU0002-11-02-BT
IF REPORT IS TYPED
STU0002-11-02-BT
OR MACHINE PRINTED
OR MACHINE PRINTED
21-3
21-3
OR MACHINE PRINTED
O O O O
O O O O
V V V V
V V V V
U U U U
U U U U
T T T T
T T T T
R R R R
R R R R
Form Number 21-3
21-3
K K K K L L L L A A A A H H H H O O O O M M M M A A A A
E E E E N N N N D D D D O O O O R R R R S S S S
S S S S E E E E
A A A A X X X X
E E E E P P P P O O O O R R R R T T T T
K K K K L L L L A A A A H H H H O O O O M M M M A A A A
E E E E N N N N D D D D O O O O R R R R S S S S
S S S S E E E E
A A A A X X X X
E E E E P P P P O O O O R R R R T T T T
Revision March 2004
SEE INSTRUCTIONS
Revision March 2004
SEE INSTRUCTIONS
O O O O
V V V V
U U U U
T T T T
R R R R
K K K K L L L L A A A A H H H H O O O O M M M M A A A A
E E E E N N N N D D D D O O O O R R R R S S S S
S S S S E E E E
A A A A X X X X
E E E E P P P P O O O O R R R R T T T T
Revision March 2004
Revised June 2010
SEE INSTRUCTIONS
D. Permit Number
D. Permit Number
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
D. Permit Number
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
H.
H.
Page
Page
of
of
Page(s)
Page(s)
H.
Page
of
Page(s)
P.T.
P.T.
Mailing
Mailing
Business
Business
G. Out of Business
G. Out of Business
-OFFICE USE ONLY-
F.C.
-OFFICE USE ONLY-
F.C.
P.T.
Mailing
Business
G. Out of Business
-OFFICE USE ONLY-
F.C.
F. Address Change
F. Address Change
F. Address Change
E. MAILING ADDRESS
E. MAILING ADDRESS
E. MAILING ADDRESS
Name
Name
Name
Address
Address
Address
City
City
State
State
ZIP
ZIP
City
State
ZIP
D
D
C
C
OLLARS
OLLARS
ENTS
ENTS
D
C
OLLARS
ENTS
1.
Sales Price of Tangible Personal Property (Do not include transportation charges)
1.
Sales Price of Tangible Personal Property (Do not include transportation charges)
.............................. 1.
.............................. 1.
1.
Sales Price of Tangible Personal Property (Do not include transportation charges)
.............................. 1.
L
D
L
D
EGAL
EGAL
EDUCTIONS
EDUCTIONS
L
D
EGAL
EDUCTIONS
2.
2.
A. Sales for Resale
A. Sales for Resale
2.
A. Sales for Resale
(Included in line 1)
(Included in line 1)
..................................................................
..................................................................
2a.
2a.
(Included in line 1)
..................................................................
2a.
B. Other Legal Deductions
B. Other Legal Deductions
B. Other Legal Deductions
(Explain fully on reverse side)
..................................................
2b.
(Explain fully on reverse side)
..................................................
2b.
(Explain fully on reverse side)
..................................................
2b.
............................................................................................................
............................................................................................................
3.
3.
Total Deductions (Total of line 2a and 2b)
Total Deductions (Total of line 2a and 2b)
3.
3.
............................................................................................................
3.
Total Deductions (Total of line 2a and 2b)
3.
.....................................................................................
.....................................................................................
4.
Balance on which Use Tax is Due (line 1 less line 3)
4.
4.
Balance on which Use Tax is Due (line 1 less line 3)
4.
.....................................................................................
4.
Balance on which Use Tax is Due (line 1 less line 3)
4.
..............................................................................................................................
..............................................................................................................................
5.
5.
Amount of tax (4.5% of line 4)
Amount of tax (4.5% of line 4)
5.
5.
..............................................................................................................................
5.
Amount of tax (4.5% of line 4)
5.
..................................................................................................................................
..................................................................................................................................
6.
6.
Discount (see instructions)
Discount (see instructions)
6.
6.
..................................................................................................................................
6.
Discount (see instructions)
6.
.............................................
.............................................
7.
7.
Interest 1.25% per month of line 5 from date delinquent to date of payment
Interest 1.25% per month of line 5 from date delinquent to date of payment
7.
7.
.............................................
7.
Interest 1.25% per month of line 5 from date delinquent to date of payment
7.
........................................................
........................................................
8.
Penalty: 10% of line 5, if not paid within 15 days from delinquent date
8.
8.
Penalty: 10% of line 5, if not paid within 15 days from delinquent date
8.
........................................................
8.
Penalty: 10% of line 5, if not paid within 15 days from delinquent date
8.
....................................................................................................................................................................
....................................................................................................................................................................
9.
9.
Subtotal:
Subtotal:
9.
9.
....................................................................................................................................................................
9.
Subtotal:
9.
...........................................................................................................................................
...........................................................................................................................................
10.
State Tax (from line 9)
10.
10.
State Tax (from line 9)
10.
...........................................................................................................................................
10.
State Tax (from line 9)
10.
..................................
..................................
11.
City/County Use Tax (sum of Supplement page(s) (and line P of Column N below)
11.
11.
City/County Use Tax (sum of Supplement page(s) (and line P of Column N below)
11.
..................................
11.
City/County Use Tax (sum of Supplement page(s) (and line P of Column N below)
11.
................................................
................................................
12.
12.
Total State and City/County due(Remit this amount) (Add lines 10 and 11)
Total State and City/County due(Remit this amount) (Add lines 10 and 11)
12.
12.
................................................
12.
Total State and City/County due(Remit this amount) (Add lines 10 and 11)
12.
D D D D
D D D D
T T T T
T T T T
C C C C
C C C C
C C C C
C C C C
I I I I S S S S T T T T R R R R I I I I B B B B U U U U T T T T I I I I O O O O N N N N O O O O F F F F
I I I I S S S S T T T T R R R R I I I I B B B B U U U U T T T T I I I I O O O O N N N N O O O O F F F F
A A A A X X X X F F F F O O O O R R R R
A A A A X X X X F F F F O O O O R R R R
I I I I T T T T I I I I E E E E S S S S / / / /
I I I I T T T T I I I I E E E E S S S S / / / /
O O O O U U U U N N N N T T T T I I I I E E E E S S S S
O O O O U U U U N N N N T T T T I I I I E E E E S S S S
D D D D
T T T T
C C C C
C C C C
I I I I S S S S T T T T R R R R I I I I B B B B U U U U T T T T I I I I O O O O N N N N O O O O F F F F
A A A A X X X X F F F F O O O O R R R R
I I I I T T T T I I I I E E E E S S S S / / / /
O O O O U U U U N N N N T T T T I I I I E E E E S S S S
J.
J.
K.
K.
M.
M.
Interest
Interest
N.
N.
O.
O.
City/
City/
I.
L.
I.
L.
J.
K.
M.
Interest
N.
O.
City/
I.
L.
City/County
City/County
and
and
County
County
Net Taxable
Net Taxable
City/County
and
County
Net Taxable
Cities/Counties
Use Tax
Discount
Penalty
Total Due
Code
Cities/Counties
Use Tax
Discount
Penalty
Total Due
Code
Sales
Sales
Cities/Counties
Use Tax
Discount
Penalty
Total Due
Code
Sales
1.
1.
1.
2.
2.
2.
3.
3.
3.
4.
4.
4.
P.
P.
TOTAL
TOTAL
P.
TOTAL
IF MORE SPACE IS NEEDED, USE SUPPLEMENT PAGE(S)
IF MORE SPACE IS NEEDED, USE SUPPLEMENT PAGE(S)
IF MORE SPACE IS NEEDED, USE SUPPLEMENT PAGE(S)
The Oklahoma Tax Commission is not required to give actual notice of changes in any State tax law.
The Oklahoma Tax Commission is not required to give actual notice of changes in any State tax law.
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
I declare under the penalties of perjury, this return (including any accompanying schedules) has been examined by me, and to the best of my
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.
knowledge and belief is a true, correct, and complete return.
knowledge and belief is a true, correct, and complete return.
Signature of Taxpayer
Signature of Taxpayer
Date
Date
Prepared by
Prepared by
Date
Date
Signature of Taxpayer
Date
Prepared by
Date

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