Form 31-004 - Iowa Registration Services

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Information Form
Use this form to report address and name changes, cancel your permit, change
your filing frequency, or request information on Electronic Funds Transfer (EFT).
Permit number
Enter weekday phone number
Location name and address
Mailing name and address
If different than above:
If different than above:
Correct location name and address: (not a PO Box)
Correct mailing name and address:
Mail Corrections,
Cancellations or
Changes to:
Registration Services
PO Box 10465
Des Moines IA 50306-0465.
QUARTERLY EXEMPTIONS
QUARTERLY EXEMPTIONS RETURN
Exemptions are sales made by you on which tax was
13 Interstate Commerce
not required to be charged. Enter your exemptions for
14 Govt Units/Educ Inst
the entire quarter on this return. Enter the amount
15 Resale/Processing
from line 21 on line 4 below.
16 Farm Machinery/Equip
17 Indust Mach, Equip, Comp
18 New Construction
19 Exempt Food/Drugs
20 Other:
Other:
Other:
21 Total Exemptions
SALES TAX QUARTERLY RETURN
IMPORTANT: You must file even if you had no sales tax activity during
IOWA
the quarter.If you had no sales, put zeroes on lines 1 and 12.
31-004 RF13A 10/02
s
1 Gross Sales (quarter)
s
2 Goods Consumed (quarter)
3 Total (add lines 1 and 2)
s
4 Exemptions (from line 21) (quarter)
5 Taxable Amount (line 3 minus line 4)
s
s
Permit No.
Period
s
6a State Sales Tax (5% of line 5) (quarter)
Date Due
s
6b Total Local Option Sales Tax (quarter)
s
6c Total School Local Option Tax (quarter)
7 Total Tax (add lines 6a, 6b, and 6c)
s
8 Deposits and Overpayment Credits
9 Balance (line 7 minus line 8)
s
10 Penalty (if applicable)
s
11 Interest (if applicable, see instructions)
Title
Signature of Retailer or Agent
Date
s
12 Total Amount Due (add lines 9-11)
Daytime Phone No.: ________________

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Parent category: Financial
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