Enhanced Food Fish Excise Tax Return Form - 2003

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State of Washington
Q4
OCT – NOV – DEC 2003
Department of Revenue
PO Box 47464
Olympia, WA 98504-7464
03
ENHANCED FOOD FISH EXCISE TAX RETURN
ONLY Fill in Box if Amended/Supplemental Return Information is Attached
!
Address Changes?
business location
mailing address
both
Business closed?
Date closed ____/____/____
!
!
!
!
Please make address changes to above label.
Return must be filed even if no tax is due.
Call (360) 902-7084 for Fish Tax assistance.
Line
Code
Per Species Indicate Pounds,
Species
Taxable Value
Rate
Tax Due
No.
No.
Gallons, Bushels, Dozens
1
Chinook Fish or Eggs
2
.0562
2
Coho Fish or Eggs
4
.0562
3
Chum Fish or Eggs
6
.0562
4
Pink Fish or Eggs
8
.0337
5
Sockeye Fish or Eggs
10
.0337
6
Other Food Fish or Eggs
15
.0225
7
Shellfish
20
.0225
8
Sea Urchin
21
.0492
9
Sea Cucumber
22
.0492
10 Oysters
25
.0009
11 Anadromous Game Fish
28
.0562
TAX DUE (Enter on line 12)
Credit For Tax Paid On Enhanced Food Fish To Other Legal Taxing Authorities
State, Tribal, or Federal
Pounds, Gallons,
Tax Rate
Species
Value
Credit
Taxing Authority Paid
Bushels, Dozens
Paid
TOTAL CREDIT not to exceed tax due (Enter and deduct on line 13)
* DUE DATE: JANUARY 31, 2004
JANUARY 2004
Line
Code
Totals
Tax Due
S
M
T
W
T
F
S
No.
No.
31
5% Penalty is Due After February 2, 2004
1
2
3
"
15% Penalty is Due After March 1, 2004
12 Tax Due
30
4
5
6
7
8
9
10
"
25% Penalty is Due After March 31, 2004
11
12
13
14
15
16
17
If the due date falls on a weekend or a
13 Credits
32
18
19
20
21
22
23
24
legal holiday, the due date for the return is
25
26
27
28
29
30
31
extended to the next business day.
14 Total Tax
36
15 Penalty
38
!
Signature
16 TOTAL AMOUNT OWED
40
Phone
Date
RETURN THIS COPY
!
If you qualify, attach penalty waiver request and fill in box
REV 41 0073 (11/5/03)
Page 1
.
!

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