Combined Excise Tax Return - State Of Washington - 2003
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5MAIL TO: State of Washington
AUGUST 2003
Department of Revenue
08
PO Box 34051
Seattle, WA 98124-1051
COMBINED EXCISE TAX RETURN
03
ONLY Fill in Box if Amended Return Information Attached
"
NAME
TAX REGISTRATION NO.
FIRM NAME
STREET ADDRESS
CITY, STATE, ZIP
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Address Changes?
business location
mailing address
both
Business closed?
Date closed ___/___/___ See Help section, pg 2.
Please fill in the appropriate box and note address changes above.
I STATE BUSINESS AND OCCUPATION TAX
Line
Column I
Col. 2 Deductions*
Column 3
Col. 4
Column 5
Tax Classification
Code
No.
Gross Amount
Totals from Pg. 3 & 4
Taxable Amount
Rate
Tax Due
1
16
Extracting, Extracting for Hire
.00484
Slaughter, Break Proc, Perish Meat-Whlse; Mfg Wheat
2
30
.00138
into Flour; Raw Seafood; Soybean & Canola Proc
Travel Agent Com/Tour Operators; Intl Charter Freight
3
28
.00275
Brokers; Stevedoring
4
14
Insurance Agents; Insurance Brokers Commis
.00484
Prescription Drug Warehousing; Mfg: Fresh Fruit & Veg,
5
21
.00138
Dairy Products, Bio/Alcohol Fuel, or Split/Proc Dried Peas
6
10
Processing for Hire; Printing and Publishing
.00484
7
Manufacturing
07
.00484
8
80
Royalties; Child Care
.00484
9
03
Wholesaling
.00484
Warehousing; Radio & TV Broadcasting; Public Rd Const;
10
11
.00484
Gov Contracting; Chem Dependency Ctr (after 7/26/03)
11
55
Public or Nonprofit Hospitals
.015
12
Cleanup of Radioactive Waste for US Gov
83
.00471
13
04
Service & Other Activities
.015
14
19
Retailing of Interstate Transportation Equip
.00484
15
02
Retailing
.00471
* Deductions taken but not itemized on pages 3 and 4 will be disallowed.
TOTAL B&O TAX
GROSS AMOUNTS FOR RETAILING AND
RETAIL SALES MUST BE THE SAME
II STATE SALES AND USE TAX
16
01
Retail Sales (also complete local tax section III)
.065
Use Tax/Deferred Sales Tax (also complete
Value of articles used by taxpayer as a consumer
17
05
.065
local tax section III)
on which no Washington sales tax has been paid
TOTAL STATE SALES & USE TAX
III LOCAL CITY AND/OR COUNTY SALES AND USE TAX
DUE DATE: SEPTEMBER 20, 2003
SEPTEMBER 2003
Local Sales Tax (Enter applicable rate of tax)
Code 45
Total Taxable Amount must be the same as line 16, column 3, Taxable Amount
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S
M
T
W
T
F
S
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5% Penalty Assessed After September 20, 2003
Line
1
2
3
4
5
6
Location Code
Taxable Amount
Local Rate
Tax Due City or Co.
15% Penalty Assessed After October 31, 2003
No.
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8
9
10
11
12
13
25% Penalty Assessed After December 1, 2003
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15
16
17
18
19
20
18
If the due date falls on a weekend or legal holiday,
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24
25
26
27
19
28
29
30
the due date is extended to the next business day.
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#
4
Please fill in this box if you had no business activity.
(see Help section, pg. 2)
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This return must be mailed, unless filed electronically.
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Please make check or money order payable to the Washington State
TOTAL
Department of Revenue. Do not send cash or coins.
TOTAL
TAXABLE
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For assistance, call (800) 647-7706.
Local Use Tax/Deferred Sales Tax (Enter applicable rate of tax) Code 46
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Signature
Total Value of Articles must be the same as line 17, column 1, Gross Amount
Line
Ph. (
)
4
Date
Location Code
Value of Articles
Local Rate Tax Due City or Co.
No.
Line
Item
VIII TOTALS
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No.
24
29
Total All Tax Due from page 1
TOTAL VALUE
TOTAL
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Total All Tax Due from page 2
OF ARTICLES
Tax
Line
31
Rental Car Tax (attach Rental Car Tax Addendum)
Code
Taxable Amount
Rate
Tax Due
No.
Classification
32
Subtotal (add lines 29-31)
Motor Vehicle
25
120
.003
Sales/Leases
33
Credit (from page 2, section VII, total credit)
Region Transit
26
89
.004
Authority (RTA)
34
Subtotal (subtract line 33 from line 32)
King County
27
90
.005
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Food & Bev
35
Add Penalty, if applicable
Minimum $5.00
28
Litter Tax
36
.00015
TOTAL AMOUNT OWED (add lines 34 - 35)
402406080301
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Penalty waiver request? Attach and fill in box.
(see Help section, pg 2)
(5-29-03)
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