Form 12 - Combined Excise Tax Return - 1999 Page 2
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4III LODGING TAXES
TRANSIENT RENTAL INCOME INFORMATION
(Enter Location Code and Income Only)
Code 47
Line
Location Code
Income
Location Code
Income
Location Code
Income
No.
37
38
CONVENTION AND TRADE CENTER TAX
SPECIAL HOTEL/MOTEL TAX
Code 48
Code 70
Line
Line
Taxable Amount
Rate
Tax Due
Location Code
Taxable Amount
Rate
Tax Due
Location Code
No.
No.
39
42
40
43
41
44
TOTAL CONVENTION & TRADE CENTER TAX
TOTAL SPECIAL HOTEL/MOTEL TAX
IV STATE PUBLIC UTILITY TAX
Line
Column I
Col. 2 Deductions*
Column 3**
Col. 4
Column 5
Tax Classification
Code
No.
Gross Amount
Totals from Pg. 4
Taxable Amount
Rate
Tax Due
Water Distribution
.05029
45
60
46
Sewer Collection
61
.03852
Power
.03873
47
49
48
Gas Distribution, Telegraph
26
.03852
49
Motor Transportation, Railroad, Railroad Car
08
.01926
Urban Transportation/Vessels Under 65 ft
.00642
50
12
51
Other Public Service Business
13
.01926
** If taxable amounts on lines 45-51 column 3 total less than $2,000, no Public Utility Tax is due.
TOTAL STATE PUBLIC UTILITY TAX
V OTHER TAXES
Line
Column I
Col. 2 Deductions*
Column 3
Col. 4
Column 5
Tax Classification
Code
No.
Gross Amount
Totals from Pg. 4
Taxable Amount
Rate
Tax Due
52
Tobacco Products
20
.7490
53
Refuse Collection
64
.036
54
Petroleum Tax
57
Temporarily Not Due - Fund Limit Reached
.005
Hazardous Substance
.007
55
65
* Deductions taken but not explained on page 4 will be disallowed.
Line
Tax Classification
Code
Item
Quantity Sold
Rate
Tax Due
No.
Number of Stoves, Fireplaces, & Solid Fuel
56
Solid Fuel Burning Device Fee
59
$30.00
Burning Devices:
57
Syrup Tax
54
Number of Gallons:
$1.00
TOTAL OTHER TAXES
(Add lines 52-57)
NOTE:
VI CREDITS
Line
Credit
Credit Classification
I.D.
Amount
1. If you do not have deductions, do not return pages 3 and 4.
No.
58
800
2. If you have deductions, complete and return pages 3 and 4.
Multiple Activities Tax Credit (attach Schedule C)
High Technology Credit
3. LOCAL CITY AND/OR COUNTY SALES AND USE TAX. For your
830
59
(attach Research & Development Credit Affidavit)
convenience, a copy of the Local City and/or County Sales and Use Tax
form was provided in the “Guide to Completing the Washington State
Manufacturing Software/Programming Rural
60
860
Combined Excise Tax Return.” If more space is required, you may
Employment B&O Credit
make copies of this form or attach additional local tax information in the
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865
Help Desk Services B&O Credit
same format.
Ride Share Credit for B&O Tax
4. For more information about the penalty waiver criteria, please call
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820
(attach Ride Share Credit Reporting Schedule)
Tax Express at (800) 334-8969, enter code 429.
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855
International Services Credit
5. For more information about business closures, please call
Tax Express at (800) 334-8969, enter code 430.
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815
Small Business B&O Tax Credit (see table enclosed)
6. To inquire about the availability of this form in an alternate format for the
Ride Share Credit for Public Utility Tax
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825
visually impaired or a language other than English, please call
(attach Ride Share Credit Reporting Schedule)
(360) 753-3217. Teletype (TTY) users may call (800) 451-7985.
Electric Utility Rural Economic Development
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870
Revolving Fund Public Utility Tax Credit
7. Need Help? If you need further information, please refer to your instruction
pamphlet, “Guide to Completing the Washington State Combined Excise
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801
Bad Debt Tax Credit (attach Schedule B)
Tax Return”, or call the Department of Revenue office nearest you, or our
toll-free number (800) 647-7706. You may also access our Internet home
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805
Hazardous Substance
page at
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810
Other Credits (attach appropriate documents)
TOTAL CREDIT (Transfer to page 1, line 33)
REV 40 2406 DEC99 (9-30-99)
Page 2
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