Admissions Tax Return Form - City Of Westminster Department Of Finance

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City of Westminster
Admissions Tax Return
Department of Finance
Sales Tax Division
REPORT ADMISSIONS TAX ONLY
A separate return is required for sales and use taxes
PERIOD:
ACCOUNT:
DUE DATE:
Revised for Tax Periods
beginning on or after
January 1, 2011
1.
GROSS SALES OF ADMISSIONS
$________________
2.
DEDUCTIONS:
$________________
A. Sales to Government and Charitable Organizations
$________________
B. Taxes Included in Gross Sales (Line 1)
$________________
C. Other _____________________________
TOTAL DEDUCTIONS (Total Lines 2A through 2C)
$________________
3.
NET TAXABLE ADMISSIONS (Line 1 less Line 2)
$________________
4.
AMOUNT OF ADMISSIONS TAX (3.00% of Line 3)
$________________
5.
ADD: EXCESS TAX COLLECTED
$________________
6.
ADMISSIONS TAX DUE (Total Lines 4 and 5)
$________________
7.
LATE FILING – If return is filed after due date, then add:
$________________
A. Penalty (10% of Line 6, $15.00 minimum)
$________________
B. Interest (1% of Line 6 per month late)
TOTAL PENALTY & INTEREST
$________________
8.
TOTAL DUE & PAYABLE (Total Lines 6 and 7)
$________________
Under penalties of perjury, I declare that I have examined this Admissions Tax Return and it is true and
correct to the best of my knowledge and belief.
Taxpayer
Signature
Signature
Date
Printed Name
Title
Phone Number
Make check payable to City of Westminster and send with completed and signed return to:
City of Westminster
Sales Tax Division
PO Box 17107
Denver, CO 80217-7107
Phone: (303) 658-2065
Fax: (303) 706-3923

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