Form Str 04 - 2004 Sales Tax Remittance Return
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4MAIL TO:
Washington State
Department of Revenue
STR
JAN - DEC 2004
PO Box 34054
Seattle WA 98124-1054
04
SALES TAX REMITTANCE RETURN
ONLY Fill in Box if Amended Return Information Attached
NAME
TAX REG. NO.
FIRM NAME
STREET ADDRESS
CITY, STATE, ZIP
Address Changes?
business location
mailing address
both
Business closed?
Date closed ____/____/____
Please fill in the appropriate box and note address changes above, if applicable.
USE BLACK INK AND RETURN ORIGINAL FORM.
This Sales Tax Remittance form replaces the Combined Excise Tax Return. If your total annual gross business income is
less than $28,000 and you owe retail sales tax under $2,000, you may report sales tax on this form (see reverse for
instructions). The business and occupation (B&O) tax is not due because the Small Business Credit will eliminate your
B&O tax liability. If your annual gross business income is greater than $28,000, you owe retail sales tax over $2,000, or
you owe taxes other than retail sales tax. Please see reverse for instructions. This return is due January 31, 2005.
Please check applicable box(es):
Finalizing Your Sales Tax Remittance Return
•
Sign, date, and provide a contact number below.
Keep a copy for your files, and mail original form
•
No Sales Tax Collected in 2004 and/or;
with your payment in the enclosed envelope.
Please do not staple or paperclip your payment to
•
Gross Business Activity totaled less than $28,000;
the form.
•
If remitting an amount different than the amount of
tax collected, please enclose an explanation.
- OR -
•
Make check or money order payable to the
Washington State Department of Revenue. Do not
No Business Activity in 2004.
mail cash or coins.
NOTE: If you would like to file “No Business
Activity” on-line or by telephone, please
see reverse for instructions.
DUE DATE: JANUARY 31, 2005
5% Penalty is Assessed After January 31, 2005
15% Penalty is Assessed After February 28, 2005
25% Penalty is Assessed After March 31, 2005
If the due date falls on a weekend or legal holiday, the
Sales Tax Collected
1)
due date is extended to the next business day.
(See item one, page 2)
Add Penalty, if applicable
2)
(Minimum $5.00)
Phone
Date
(
)
/
/
Signature
TOTAL AMOUNT OWED
3)
(add lines 1 and 2)
Internet/Fax
Penalty waiver request? Attach and fill in box.
(see ** instructions on reverse)
(11-2-04)
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