Form Sls 450 - State And Local Sales And Use Tax Return - Tennessee Department Of Revenue
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3RV-R0000201
INTERNET (03/17)
PAGE 1
TENNESSEE DEPARTMENT OF REVENUE
For assistance, contact the Taxpayer Services Division at
STATE AND LOCAL SALES AND USE TAX RETURN
(800) 342-1003, (615) 253-0600 or
ACCOUNT NO.
Filing
}
Period
If this is an AMENDED RE-
SLS
TURN, please check the box at
450
LOCATION
ADDRESS
Due
right
Date
LOCATION ID
If this is a FINAL RETURN for a
}
closed business, please check the
box at right
If this is a CHANGE OF MAILING
}
ADDRESS, please check the box
at right
ROUND TO NEAREST DOLLAR; WRITE NUMBERS LIKE THIS
00
(1)
1.
Gross Sales..........................................................................................................
(2)
00
(2)
2.
Cost of Personal Property Purchased on a Resale Certificate but Used........................
00
(3)
Cost of Out-of-State Purchases and Property Imported into Tennessee for Use.............
(3)
3.
4.
Fair Market Value of Tangible Personal Property Fabricated, Produced, Compounded, or
00
(4)
Severed From the Earth for Use in Tennessee...........................................................
00
(5)
Total Sales and Purchases - Add Lines 1 Through 4....................................................
5.
.
00
(6)
6.
Exempt Transactions from Schedule A, Line 11.........................................................
00
(7)
7.
State Net Taxable Total - Subtract Line 6 from Line 5.................................................
00
State Sales and Use Tax (Non-food Sales and Purchases x 7%).................................
8.
(8)
00
(9)
State Food Tax
(Food Sales x 5%)................................................
9.
00
00
(10)
Local Sales and Use Tax from Schedule B, Line 8...........................
10.
00
11.
Tax Collected in Excess of State and Local Levies....................................................
(11)
12.
State Tax on Transactions Subject to Single Article and Reduced Rates from Schedule
00
(12)
C, Line 9..............................................................................................................
13.
Local Tax on Transactions Subject to the Special Tax Rate From Schedule C, Line
00
(13)
15.......................................................................................................................
00
14.
Central Business Improvement District Fee from Schedule D, Line 10.........................
(14)
Prepaid Wireless 911 Surcharge -
$1.16 per retail transaction for prepaid wireless
15.
00
telecommunications less 3% administrative fee....................................................
(15)
00
Total Tax Before Penalty and Interest - Add Lines 8, 9, 10, 11, 12, 13, 14, and 15.........
16.
(16)
00
Credit Memo Balance..............................................................................................
(17)
17.
00
18.
Penalty (See Instructions)........................................................................................
(18)
00
19.
Interest (See Instructions) .......................................................................................
(19)
Total Due - If filed timely, subtract Line 17 from Line 16; if filed late, subtract
20.
00
Line 17 from Line 16 and add Lines 18 and 19...........................................................
(20)
FOR OFFICE USE ONLY
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