Sales Tax Return - City & County Of Broomfield Sales Tax Administration Division
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SALES
CITY & COUNTY OF BROOMFIELD
FILING PERIOD
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TAX
•
RETURN
•
Sales Tax Administration Division
COCORA00
P.O. Box 407
NOTE:
You must file this return
B
fi ld CO 80038 0407
Returns not postmarked by
room e ,
-
even if line 15 is zero $
h
d
i
e due ate w ll be late
t
If filing a Consolidated Return, OR advising of changes on
Due Date
State Sales Tax #
City License #
page 2, please place a LARGE X in box at right >>>>
6. Excess Tax Collected
$
(See instructions)
7. Sub-Total of Sales Taxes:
$
(Line 5 plus line 6)
8. Vendor Fee: (Line 7 multiplied by 3%)
$
(.03)
Maximum=$200
Enter -0- on Late Returns
Message:
Changes have been made on Page 2 :
9. Net Broomfield City and
$
See Block #F-Sales of Cigarettes (gasoline
County Sales Tax:
moved to Block # I-Sales of Lottery & Gasoline).
(Line 7 minus line 8)
10. Lodging Tax: Balance due from
$
Lodging Tax Return (Attach copy of return)
1. GROSS SALES & SERVICES:
(Round to even $)
11. FID/ALID TAX:
(Total receipts, before sales tax, from City &
Flatiron Improvement District (FID) or
$
County activity must be reported including all
$
Arista Local Improvement District (ALID)
sales, rentals, leases, & services, both
Line 4 multiplied by.2% (.002) or
taxable and non- taxable)
FID Gross amount $-if applicable
la. ADD-Bad Debts Collected:
$
12. Late Filing Penalty:
$
(which were previously deducted)
(See Instructions)
2.
Adjusted Gross Sales &
$
13. Interest:
$
Services: (Line 1 plus 1a)
(See instructions)
3.
Exemptions:
$
14. Adjustments:
$
(Please insert total of Line 3,
(Attach Authorization Letter)
from page 2)
See Instructions
4.
Net Taxable Sales & Services:
$
15. Total Due and Payable:
$
(Line 2 minus line 3)
(Add Line 9 through line 13) Minus 14
if credit is authorized; Plus 14 if a
debit is reouiredl
5. Broomfield City and County
$
Make Check or Money Order Payable to:
Sales Tax: (Line 4 multiplied by
4.15%) (.0415)
City and County of Broomfield
(
Continued on Line 6)
Business Location
Phone:
303-464-5811
Fax: 303-410-3802
Email:
salestax@broomfield.orci
Web :
My signature affirms that I have read this return and it is true and correct to the best of my knowledge and is signed subject to penalties
for perjury and other criminal offenses.
Signature:
Date:
Title:
Phone:
Fax:
Email:
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