Sales Tax Return Form - City And County Of Broomfield Page 2
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1
2CITY & COUNTY OF BROOMFIELD
Sales Tax Return
Page 2
Line 3 (Detail)
Exempt Sales
(See page 3 for instructions)
A
Non-Taxable Service or Labor:
$
B
Sales to Licensed Dealers: (Must support exemption with valid Resale Number)
$
C
Sales Shipped Out of the City & County of Broomfield:
$
D
Bad Debts Charged Off: (On which tax was previously paid):
$
E
Trade-ins: (Where property will be resold at taxable value)
$
F
Sales of Cigarettes
$
G
Exempt Sales: (Government, religious, & charitable organizations)
$
H
Returned Goods: (on which tax was previously paid)
$
I
Sales of Lottery and Gasoline:
$
J
Prescription Drugs, and other exempt medical transactions:
$
Food purchased with Food Stamps or WIC Vouchers: (Does not include “Food for Home
K
$
Consumption” sold without stamps or vouchers) (See Instructions)
Sales of Building Materials: (Only when supported by a Building Permit, showing Local Use Tax
L
$
paid, and the permit number is shown on invoice)
M
Miscellaneous exempt sales: (Please explain)
$
Line 3: Total Exemptions: (Total of Line A though Line N)
$
(Carry amount to line 3 on Page 1)
SCHEDULE B: CONSOLIDATED ACCOUNT REPORT
This schedule is required in all cases where the vendor is reporting sales for more than one location within the City and County of Broomfield. Each location must have
a separate license.(Attach a separate spreadsheet if necessary)
Total Gross Sales
Account
Business
For Reporting
Total
Net
Number
Location Address
Period
Exemptions
Taxable Sales
$
$
$
$
$
$
$
$
$
Totals:
$
$
$
ADDRESS CHANGES:
BUSINESS STATUS CHANGES:
Mailing address: _________________________
1) Ownership (Date, New Owner and Phone)
City, State
________________________
____________________________________
Zip:
_________________________
____________________________________
Location address: _________________________
2) Business Closure: (Date) _______________
Email: __________________________________
Phone: __________________________________
3) Filing frequency: (Call or Email for change)
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