Sales Tax Return - City & County Of Broomfield Sales Tax Administration Division 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)
$
1. Sales of Lottery & Gasoline:
$
J. Prescription Drugs, and other exempt medical transactions:
$
K. Food purchased with Food Stamps or WIC Vouchers: ( Does not include "Food
$
for Home Consumption" sold without stamps or vouchers) (See Instructions)
L. Sales of Building Materials: (Only when supported by a Building Permit, showing
$
Local Use Tax paid, and the permit number is shown on invoice)
M. Annual Restaurant Utility Adjustment: (Deduct only on first return of year,
$
[February for monthly filers, April for quarterly] and support with DR 1465 form)
N. 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)
Account
Business Location
Total Gross Sales
Total
Net Taxable
Number
Address
For Reporting Period
Exemptions
Sales
Totals:
$
$
$
ADDRESS CHANGES:
BUSINESS STATUS CHANGES:
Mailing address:
1) Ownership (Date, New Owner and Phone)
City, State
Zip:
Location address:
2) Business C losure: (Date)
Email:
Phone:
3) Filing frequency: (Call or Email for change)
Fax:
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