Ets Form 027 - Direct Pay Permit Sales Tax Application

Ets Form 027 - Direct Pay Permit Sales Tax Application - 2001 Page 2

State of Wyoming

Department of Revenue

Direct Pay Permit No:

Direct Pay Start Date:

SIC:

The purchaser shown below has registered with the Department of Revenue and has been authorized to accrue the sales tax imposed by

the sales/use Tax Act of 1937, as amended, and to remit the tax directly to the Department rather than to the vendor from whom

purchases are made. This authorization shall be valid and effective until cancelled or revoked and is not transferable.

Location:

Director, Department Of Revenue

Issue Date:

Direct pay permit holders shall furnish each vendor with a copy of their direct pay permit

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Cut along this line to separate permit. Please retain the information below for your reference.

WYOMING DIRECT PAY PERMIT TAX REPORTING INFORMATION

Your filing frequency is

beginning:

You will receive your return approximately the first week of the month in which it is due. Example: MONTHLY filers;

January return will be received first half of February and it must be postmarked on or before the last day of February.

Failure to receive a return from the Department of Revenue does not relieve you from the responsibility of filing

and paying the tax due on or before the due date. *Call our office for a duplicate return, if you have not

received a return by the 15th of the month.

Returns must be filed even if no purchases were made or any tax

due.

The postmark date determines the timeliness of your return. Returns with a late postmark are subject to a 10% penalty

plus a monthly interest rate to be determined by the State Treasurer under W.S. 39-15-108, which is calculated on a

daily basis.

Please notify your Regional Section at the Cheyenne Office in writing if there is a change of address or ownership.

Mail to : Department of Revenue, 122 W 25 th St., Cheyenne WY 82002-0110. Be sure to include your Wyoming

Direct Pay Permit number on any correspondence and/or remittance sent to the Department to ensure timely pro-

cessing.

Contact your local Field Representative (identified on the enclosed listing) or Taxpayer Services at 307-777-5200

P e r m i t # :

Direct Pay Start Date

Lic. Issue Date

DBA:

Owner:

Mailing Address:

Location Address:

Ets Form 027 - Direct Pay Permit Sales Tax Application - 2001 Page 2

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