Form Bfs Psct Oahu-2 - Public Service Company Tax - Annual Statement

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CITY AND COUNTY OF HONOLULU
Department of Budget and Fiscal Services
Amended
PUBLIC SERVICE COMPANY TAX
Annual Statement
For a PSC operating on a calendar year basis, complete and file by April 20 of each year.
Year
FILING YEAR
Print or Type
Federal Employer I.D. No.
Hawaii Tax I.D. No.
W
Name of Company
dba (if any)
Address (Number & Street)
City, State and Zip Code
(a)
(b)
STATE TOTAL
OAHU DISTRICT
1. Taxable Gross Income-State of Hawaii Form U-6, Section II, Part I, Line A
(Attach State of Hawaii Form U-6; if applicable, include computation of county
income allocation and explanation of income allocation methodology.)
$
$
2. Total Company Net Income
(Attach Income Statement)
$
3. Ratio % = Total Company Net Income/Total Company Gross Income
%
4. Tax Rate (Compute in accordance with HRS 239-5; not less than
1.885%)
%
5. Total Tax (Multiply Line 1 (b) by Line 4.)
$
6. Tax Payments Made
$
7. Tax Due (Overpaid)
$
Identify payment schedule; place an X in applicable box.
ANNUAL
QUARTERLY
MONTHLY
Mailing Address: City and County of Honolulu
Department of Budget and Fiscal Services, Administration Fiscal
th
650 South King Street, 4
Floor
Honolulu, HI 96813
I declare, under the penalties set forth in HRS, §231-36, that this annual statement, including any accompanying statements, has been examined
by me and, to the best of my knowledge and belief is a true, correct, and complete statement, made in good faith, for the filing year stated, pursuant
to the Public Service Company Tax Law, HRS, Chapter 239.
Sign and Print Name
Title
Telephone Number
Date
BFS PSCT OAHU-1
Revised 03/06/09

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