Form 21-3-A - Oklahoma Vendor Use Tax Report Supplement

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STU
4200800
333
Q.
IF REPORT IS TYPED
O
STU0002-01-99-BT
KLAHOMA
OR MACHINE PRINTED
21-3-A
V
U
T
R
S
ENDOR
SE
AX
EPORT '
UPPLEMENT'
SEE INSTRUCTIONS
D. Permit Number
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
H.
Page
of
Page(s)
-OFFICE USE ONLY-
F.C.
P.T.
Mailing
Business
G. Out of Business
F. Address Change
E. MAILING ADDRESS
D
T
C
C
ISTRIBUTION OF
AX FOR
ITIES/
OUNTIES
O.
I.
J.
K.
L.
M.
Interest
N.
City/
Net Taxable
City/County
and
County
Sales
Use Tax
Discount
Penalty
Total Due
Code
Cities/Counties
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
P.
Total City/County Tax (line 5 through
line 24)(Enter amount on page 1, line11)
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.
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.
Signature of Taxpayer
Date
Prepared by
Date

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