Fillable Form Ia 843 - Claim For Refund - 2002 (Page 2 of 2) in pdf

Form Ia 843 - Claim For Refund - 2002 Page 2

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Computation of Local Option Sales Tax

Claim Period _______ to ________

TAX

COUNTY

ORIGINAL

CORRECTED

L/O TAX TO BE

SILO TAX TO BE

PERIOD

NUMBER

TAX PAID

AMOUNT

REFUNDED

TOTALS

Total Combined Local Option Tax Due (Enter on front side of claim (line 2)

Instructions for IA 843

*If this is a correction to a sales tax return, you need to file an amended return.

Vehicle Use Tax:

Who May File

Any taxpayer who

Local Option Tax:

All claims must

Individual:

Where to File:

Sole Proprietors:

Partnerships and Corporations:

Who Must Sign

Where is My Sales/Use Refund?

Other Assistance

Supporting Documentation Required Before the

Claim can be Processed

Retail Sales/Use Tax, Consumer’s Use Tax:

IOWA COUNTIES AND COUNTY NUMBERS

Fuel Used in Processing and Implements of Husbandry:

01-ADAIR

26-DAVIS

51-JEFFERSON

76-POCAHONTAS

02-ADAMS

27-DECATUR

52-JOHNSON

77-POLK

0 3 - A L L A M A K E E

2 8 - D E L A W A R E

53-JONES

78-POTTAWATTAMIE

04-APPANOOSE

29-DES MOINES

54-KEOKUK

79-POWESHIEK

05-AUDUBON

30-DICKINSON

55-KOSSUTH

80-RINGGOLD

06-BENTON

31-DUBUQUE

56-LEE

81-SAC

07-BLACK HAWK

32-EMMET

57-LINN

82-SCOTT

08-BOONE

33-FAYETTE

58-LOUISA

83-SHELBY

09-BREMER

34-FLOYD

59-LUCAS

84-SIOUX

10-BUCHANAN

35-FRANKLIN

60-LYON

85-STORY

11-BUENA VISTA

36-FREMONT

61-MADISON

86-TAMA

Farm and Industrial Machinery and Equipment:

12-BUTLER

37-GREENE

62-MAHASKA

87-TAYLOR

13-CALHOUN

38-GRUNDY

63-MARION

88-UNION

14-CARROLL

39-GUTHRIE

64-MARSHALL

89-VAN BUREN

1 5 - C A S S

40-HAMILTON

65-MILLS

90-WAPELLO

16-CEDAR

41-HANCOCK

66-MITCHELL

91-WARREN

17-CERRO GORDO

42-HARDIN

67-MONONA

92-WASHINGTON

Computers:

18-CHEROKEE

43-HARRISON

68-MONROE

9 3 - W A Y N E

19-CHICKASAW

44-HENRY

69-MONTGOMERY

94-WEBSTER

20-CLARKE

45-HOWARD

70-MUSCATINE

95-WINNEBAGO

21-CLAY

46-HUMBOLDT

71-O’BRIEN

96-WINNESHIEK

22-CLAYTON

47-IDA

72-OSCEOLA

97-WOODBURY

23-CLINTON

48-IOWA

73-PAGE

98-WORTH

24-CRAWFORD

49-JACKSON

74-PALO ALTO

99-WRIGHT

25-DALLAS

5 0 - J A S P E R

75-PLYMOUTH

22-009b (6/20/02)

Form Ia 843 - Claim For Refund - 2002 Page 2

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