Form G-54 - Periodic General Excise/use Tax Return - 2004
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FORM G-54
STATE OF HAWAII — DEPARTMENT OF TAXATION
DO NOT WRITE IN THIS AREA
12
(REV. 2004)
— AMENDED —
PERIODIC GENERAL EXCISE/USE TAX RETURN
NAME:
£
MONTH OF _______________ , ________
(Do not combine your income for more than one month, if filing monthly.)
£
_ _ _ _ _ _ _ _ - _ _
W
QUARTER OF ______________ , ________
HAWAII TAX I.D. NO.
(Do not combine your income for more than one quarter, if filing quarterly.)
£
SEMIANNUAL PERIOD OF ______________________________ , ________
(Do not combine your income for more than one semiannual period, if filing semiannually.)
THIS FORM SHOULD NOT BE USED AFTER THE ANNUAL RETURN AND RECONCILIATION HAS BEEN FILED.
SCHEDULE A — ACTIVITIES UNDER CHAPTER 237, HRS — GENERAL EXCISE TAX LAW
BUS.
VALUES, GROSS PROCEEDS
EXEMPTIONS/DEDUCTIONS
BUSINESS
TAXABLE INCOME
RATE
TAXES
ACT.
OR GROSS INCOME
(EXPLAIN ON REVERSE SIDE)
ACTIVITIES
CODE
a
b
c
d
(column a minus column b)
WHOLESALING
1
.005
1
MANUFACTURING
2
.005
2
PRODUCING
3
.005
3
SUGAR PROCESSING
4
.005
4
PINEAPPLE CANNING
5
.005
5
SERVICES RENDERED FOR
6
.005
6
(OR TO) AN INTERMEDIARY
INSURANCE COMMISSIONS
7
.0015
7
RETAILING
8
.04
8
SERVICES INCL. PROFESSIONAL
9
.04
9
CONTRACTING
10
.04
10
THEATER AMUSEMENT AND
11
.04
11
BROADCASTING
INTEREST
12
.04
12
COMMISSIONS
13
.04
13
TRANSIENT ACCOMMODATIONS
14
.04
14
RENTALS
OTHER RENTALS
15
.04
15
ALL OTHERS
16
.04
16
SCHEDULE B — ACTIVITIES UNDER CHAPTER 238, HRS — USE TAX LAW
IMPORTS FOR RESALE AT RETAIL 17
.005
17
IMPORTS FOR CONSUMPTION
18
.04
18
19. TOTAL TAXES DUE (ADD LINES 1 — 18)
19
20. PENALTIES $
INTEREST $
ASSESSED DURING THE PERIOD
20
21. TOTAL AMOUNT DUE (ADD LINES 19 AND 20)
21
22. TOTAL TAXES PAID FOR THE PERIOD
22.
22
23. ADDITIONAL ASSESSMENTS PAID FOR THE PERIOD, IF INCLUDED ON LINE 19
23.
23
24. PENALTIES $
INTEREST $
PAID DURING THE PERIOD
24.
24
25. TOTAL PAYMENTS MADE (ADD LINES 22 — 24)
25
26. IF LINE 25 IS LARGER THAN LINE 21, ENTER CREDIT TO BE REFUNDED (LINE 25 MINUS LINE 21)
26
27. IF LINE 21 IS LARGER THAN LINE 25, ENTER TAXES NOW DUE AND PAYABLE (LINE 21 MINUS LINE 25)
27
28a. PENALTY
28. FOR LATE FILING ONLY:
28
28b. INTEREST
29. TOTAL AMOUNT NOW DUE AND PAYABLE (ADD LINES 27 AND 28)
29
30. PLEASE ENTER AMOUNT OF YOUR PAYMENT. (Attach your check or money order payable to
30
“HAWAII STATE TAX COLLECTOR” in U.S. dollars drawn on any U.S. bank AND Form VP-1 to Form G-54.
Write “GE”, the filing period, and your Hawaii Tax I.D. No. on your check or money order.)
31. GRAND TOTAL EXEMPTIONS/DEDUCTIONS FROM BACK OF FORM.
31.
I declare, under the penalties set forth in sections 231-36, HRS, that this is a true and correct return, prepared in
accordance with the provisions of the General Excise and Use Tax Laws and the rules issued thereunder.
IN THE CASE OF A CORPORATION OR PARTNERSHIP, THIS RETURN MUST BE SIGNED BY AN OFFICER, PARTNER OR MEMBER, OR DULY AUTHORIZED AGENT.
SIGNATURE
TITLE
DATE
MAILING ADDRESS: HAWAII DEPARTMENT OF TAXATION, P. O. Box 1425, Honolulu, HI 96806-1425
12
FORM G-54
THIS SPACE FOR DATE RECEIVED STAMP
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