Form Urt-1 - 2008 Indiana Utility Receipts Tax Return
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1
2Indiana Department of Revenue
2008 Indiana Utility Receipts Tax Return
Form URT-1
Calendar Year Ending December 31, 2008 or Other Tax Year
State Form 51102
(R4/8-08)
Beginning
___________/_______/2008 and Ending
BB
__________/_______/_______
AA
Check box if amended.
Check box if name changed.
A1
B1
Federal Identification Number
Name
A
B
Street Address
County
Principal Business Activity Code
C
D
H
Telephone Number
City
State
ZIP Code
(
)
E
I
F
G
K Check accounting method used:
Cash
Accrual
1
2
L Do you have on file a valid extension of time to file your return (federal Form 7004 or an electronic extension of time)?
2
1
Yes
No
M Check all boxes that apply to entity:
Initial Return
Final Return
Consolidated Return
In Bankruptcy
4
1
2
3
Taxable Receipts for Indiana (List utility receipts received during your taxable year.)
1.
1. Retail sale of utility services ...........................................................................................................................................................
2.
2. Judgments or settlements as compensation for lost retail sales ...................................................................................................
3.
3. Sales to a reseller if utility is used in hotels, mobile home parks or marinas ................................................................................
4.
4. Sales of water or gas to another for rebottling ...............................................................................................................................
5.
5. Installation, maintenance, repair, equipment or leasing services provided and charges for removal ..........................................
6.
6. All other receipts not segregated between retail and nonretail transactions ................................................................................
7.
7.
Total Taxable Receipts (add lines 1 through 6)............................................................................................................................
Deductions
8.
8. Annual taxpayer deduction ($83.33 per month, not to exceed $1,000 in a taxable year) .............................................................
9.
9. Bad debts on utility receipts of an accrual basis taxpayer .............................................................................................................
10.
10. Depreciation on resource recovery systems prorated for amount attributed to taxable year .......................................................
11. Receipts exempt from taxation if included in taxable receipts for the Mobile Telecommunications Sourcing
Act or IC 6-8.1-15. ...........................................................................................................................................................................
11.
12.
Amount paid on customarily returned empty reusable containers ................................................................................................
12.
13.
Receipts from sale of bottled water or gas that was previously taxed ...........................................................................................
13.
14.
14.
Total Deductions (add lines 8 through 13)....................................................................................................................................
15.
15.
Indiana Taxable Utility Receipts (subtract line 14 from line 7) ...................................................................................................
Tax and Credits
16.
16.
Utility Receipts Tax Due for the taxable year: Multiply the amount on line 15 by 1.4% (.014) .................................................
17.
Sales/Use Tax Due on purchases subject to use tax (from worksheet) .......................................................................................
17.
18.
Estimated payments made for utility receipts tax (list quarterly URT-Q payments below)
18.
Qtr. 1___________
Qtr. 2___________
Qtr. 3___________
Qtr. 4___________ Enter Total .......
a
b
19c
19.
Prior year overpayment credit ___________ and this year's extension payment ___________ Enter Total... .................
20b
20.
Enter name of other tax credit ________________________________________ Code No. a ____ ____ ____
b
21.
21.
Total Payments and Credits (add lines 18 through 20b) ................................................................................... ..........................
22.
22.
Net Tax Due (subtract line 21 from the sum of lines 16 and 17; if line 21 is greater proceed to line 23 and 27)..........................
23.
23.
Penalty for underpayment of estimated tax (from completed Schedule URT-2220) .....................................................................
24.
24.
Interest: If payment is made after the original due date, add interest (for rates refer to Department Notice #3).. .......................
25.
25.
Penalty for late payment: See instructions .....................................................................................................................................
26.
26.
Total Amount Owed (add lines 22 through 25).............................................................................................................................
27.
27.
Overpayment (line 21 minus lines 16, 17 and 23) ........................................................ ..................................................................
28.
28.
Refund (portion of amount on line 27 to be refunded......................................................................................................................
29.
29.
Overpayment Credit (carryover to the following year's estimated URT account, line 27 minus line 28) ...................................
Certification of Signatures and Authorization Section
Under penalties of perjury, I declare I have examined this return, including all accompanying schedules and statements, and to the best of my knowledge and belief it is true,
correct and complete.
E-mail address
EE
I authorize the Department to discuss my return with my personal representative
(see page 7)
2
FF
CC 1
Yes
No
Paid Preparer: Firm’s Name (or yours if self-employed.)
Signature of Officer
Date
Check One:
[ ] Federal I.D. Number
[ ] PTIN OR
[ ]Social Security Number
OO
1
2
3
LL
MM
Print or Type Name of Officer
Title
NN
QQ
Telephone number
PP
Personal Representative’s Name (Print or Type)
GG
Address
Telephone number
RR
HH
City
Address
SS
II
JJ
State
ZIP Code + 4
City
TT
Paid Preparer's Signature
Date
State
UU
ZIP Code + 4
VV
Please mail forms to: Indiana Department of Revenue, P.O.Box 7228, Indianapolis, IN 46207-7228
*130081101*
130081101
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