Form 31-004 - Iowa Registration Services Page 2

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Information Form
Check here to cancel
your permit and enter the last
Filing Frequencies
date of making taxable sales:
Are you using the correct filing frequency?
Check our Web site for the current filing frequency thresholds.
______________________
Check here to change
your filing frequency. Enter
the filing frequency you are
changing to and the effective
Permits cannot be transferred
date:
Permits cannot be transferred from one owner to another or from one type of business to
______________________
another, for example, when changing from a sole proprietorship to a corporation. The
prior owner must cancel his/her permit and the new owner must apply for a new permit.
Check here if you want
information on paying tax
electronically (EFT filing).
IOWA REGULAR LOCAL OPTION TAX AND SCHOOL LOCAL OPTION TAX
effective January 1, 2003, through June 30, 2003
Taxable Sales
Taxable Sales
Taxable Sales
Taxable Sales
Taxable Sales
Taxable Sales
LocalOption
S c h o o l
LocalOption
S c h o o l
Local Option
S c h o o l
GREENE
37
.00
.00
P A G E
73
.00
.00
A DA IR
01
.00
.00
PALO ALTO
74
.00
.00
A D A M S
02
.00
.00
GRUNDY
38
.00
.00
PLYMOUTH
75
.00
.00
A L L A M A K E E
03
.00
.00
GUTHRIE
39
.00
.00
APPANOOSE
04
.00
.00
HAMILTON
40
.00
.00
POCAHONTAS
76
.00
.00
HANCOCK
41
.00
.00
P O L K
77
.00
.00
AUDUBON
05
.00
.00
POTTAWATTAMIE78
.00
.00
BENTON
06
.00
.00
HARDIN
42
.00
.00
P O W E S H I E K
79
.00
.00
BLACK HAWK
07
.00
.00
HARRISON
43
.00
.00
RINGGOLD
80
.00
.00
BOONE
08
.00
.00
HENRY
44
.00
.00
HOWARD
45
.00
.00
SAC
81
.00
.00
B R E M E R
09
.00
.00
SCOTT
82
.00
.00
BUCHANAN
10
.00
.00
HUMBOLDT
46
.00
.00
S H E L B Y
83
.00
.00
BUENA VISTA
11
.00
.00
IDA
47
.00
.00
SIOUX
84
.00
.00
BUTLER
12
.00
.00
I O W A
48
.00
.00
CALHOUN
13
.00
.00
JACKSON
49
.00
.00
STORY
85
.00
.00
.00
T A M A
86
.00
.00
CARROLL
14
.00
.00
J A S P E R
50
.00
.00
TAYLOR
87
.00
.00
C A S S
15
.00
.00
JEFFERSON
51
.00
.00
.00
CEDAR
16
.00
.00
JOHNSON
52
.00
.00
UNION
88
.00
.00
J O N E S
53
.00
.00
VAN BUREN
89
.00
.00
CERRO GORDO
17
.00
.00
WAPELLO
90
.00
.00
CHEROKEE
18
.00
.00
KEOKUK
54
.00
.00
WARREN
91
.00
.00
C H I C K A S A W
19
.00
.00
KOSSUTH
55
.00
.00
WASHINGTON
92
.00
.00
CLARKE
20
.00
.00
LEE
56
.00
.00
C L A Y
21
.00
.00
LINN
57
.00
.00
W A Y N E
93
.00
.00
See below.
WEBSTER
94
Webster is the only county with a rate of 1/2% for each tax.
CLAYTON
22
.00
.00
LOUISA
58
.00
.00
WINNEBAGO
95
.00
.00
CLINTON
23
.00
.00
L U C A S
59
.00
.00
WINNESHIEK
96
.00
.00
CRAWFORD
24
.00
.00
LYON
60
.00
.00
.00
D A L L A S
25
.00
.00
MADISON
61
.00
.00
WOODBURY
97
.00
.00
WORTH
98
.00
.00
D A V I S
26
.00
.00
M A H A S K A
62
.00
.00
WRIGHT
99
.00
.00
DECATUR
27
.00
.00
MARION
63
.00
.00
DELAWARE
28
.00
.00
MARSHALL
64
.00
.00
TOTAL
TAXABLE SALES
.00
.00
MILLS
65
.00
.00
DES MOINES
29
.00
.00
MULTIPLY BY .01
.00A
.00B
DICKINSON
30
.00
.00
MITCHELL
66
.00
.00
WEBSTER CO.
94
DUBUQUE
31
.00
.00
MONONA
67
.00
.00
TOTAL
TAXABLE SALES
.00
.00
E M M E T
32
.00
.00
MONROE
68
.00
.00
MULTIPLY BY .005
.00C
.00D
FAYETTE
33
.00
.00
MONTGOMERY
69
.00
.00
ADD A & C
ADD B & D
MUSCATINE
70
.00
.00
TOTAL TAX
.00
.00
FLOYD
34
.00
.00


ENTER ON FRONT
ENTER ON FRONT
FRANKLIN
35
.00
.00
O’BRIEN
71
.00
.00
OF RETURN, LINE 6b
OF RETURN, LINE 6c
.00
FREMONT
36
.00
.00
OSCEOLA
72
.00
.00

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