Form G-54 - Periodic General Excise/use Tax Return - 2004 Page 2
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2FORM G-54
(REV. 2004)
LIST DETAILS CONCERNING “EXEMPTIONS” AND “DEDUCTIONS” CLAIMED.
If claims are not explained here, deductions and/or exemptions will be disallowed and proposed assessments prepared against
you. If you are claiming a deduction for payments to subcontractors, you must indicate the subcontractor’s name and general
excise license number. If claiming a deduction for certain leases and subleases of real property, complete Form G-72 and enter
the amount of your sublease deduction below. You must also list the name and general excise tax license number of the Lessor
and the total amount you paid the Lessor.
EXEMPTIONS AND DEDUCTIONS
SCHEDULE A — ACTIVITIES UNDER CHAPTER 237, HRS — GENERAL EXCISE TAX LAW
LINE NO.
AMOUNT
SUBTOTAL — SCHEDULE A
SCHEDULE B — ACTIVITIES UNDER CHAPTER 238, HRS — USE TAX LAW
LINE NO.
AMOUNT
SUBTOTAL — SCHEDULE B
GRAND TOTAL (Transfer to front page, line 31.)
(If more space is needed, please attach your schedule.)
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