MAIL TAX RETURNS TO:
City of Bellevue
A
LOCKBOX
MULTI-PURPOSE TAX RETURN
PO BOX 34372
08
SEATTLE, WA 98124-1372
For more information contact:
Date Due
Reporting Period
Registration #
CITY OF BELLEVUE
12/31/08
Tax Division
JAN-DEC
PO Box 90012
Bellevue, WA 98009-9012
o Check this box if there are account changes and/or updates.
Please note the changes on the back of this form.
Section 1 Business & Occupation Tax - GROSS RECEIPTS
Line
Column 1
Code
Column 2
Column 3
Column 4
Column 5
Column 6
Tax Classification
No.
Gross Receipts
Deductions*
Taxable Receipts
Tax Rate
Tax Due
No.
1
Wholesaling
02
0.001496
2
Retailing/Retail Services
03
0.001496
3
Service & Other (Not apportioned)
06
0.001496
4
Service & Other (Apportioned) *
06
Use schedule A - - - - - - - - - - - - - - -
0.001496
5
Manufacturing/Processing for Hire
01
0.001496
6
Printing/Publishing
04
0.001496
7
Extracting/Extracting for Hire
11
0.001496
8
Less Multiple Activities Tax Credit*
20
Use schedule C - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
(
)
9
Taxable Receipts Sub-Total - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Sub-Total
(If taxable receipts are less than $135,000 then no GROSS RECEIPTS TAX is due)
Section 2 Business & Occupation Tax - SQUARE FOOTAGE
10
Square Footage *
10
Use schedule B - - - - - - - - - - - - - -
.8452
(If taxable square footage is less than 250 square feet then no square footage tax is due)
Section 3 Utility Taxes
11
Telephone
40
0.060
12
Cellular
41
0.060
13
Gas
42
0.050
14
Light & Power
43
0.050
15
Cable TV
44
0.048
16
Water
45
0.050
17
Solid Waste
46
0.045
18
Sewer
47
0.050
19
Storm Drainage
48
0.050
20
Utility Tax Sub-Total - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Sub-Total
Section 4 Other Taxes
21
Amusement Games
60
0.020
22
Pull Tabs/Punch boards
61
0.050
23
Bingo
62
0.050
24
Raffles
63
0.050
25
Admission Charges
64
0.030
Other Tax Sub-Total - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Sub-Total
Tax Sub-Totals
*To be allowed deductions and credits, you must complete appropriate schedules.
Account Balance
Penalties -
(see back)
Name
___________________________________________________
(please print)
Interest -
5% per annum
Total Due
Title ______________________________________________________________
Please make checks payable to the City of Bellevue
Phone ____________________________________________________________
I hereby certify that the statements and information provided on this tax return are true and complete to the best of my knowledge.
Signature
Date
Phone: 425-452-6851 • FAX: 425-452-6198 • tax@bellevuewa.gov
m8486.02/09.ind