Form 31-089 Rf04 - Iowa Sales Tax Quarterly Return/iowa Sales Tax Quarterly Return Page 3
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1
2
3Check here to cancel
Information Form
your permit and enter the last
Use this form to report address and name changes, cancel your permit, change
date of making taxable sales:
your filing frequency, or request information on Electronic Funds Transfer (EFT).
______________________
Permit number
Enter weekday phone number
Check here to change
your filing frequency. See
explanations on the back of
Location name and address
Mailing name and address
this form. Enter the filing
frequency you are changing
to and the effective date:
______________________
Check here if you want
information on paying tax
If different than above:
If different than above:
electronically (EFT filing).
Correct location name and address: (not a PO Box)
Correct mailing name and address:
Mail Corrections,
Cancellations or
Changes to:
Registration Services
PO Box 10465
Des Moines IA 50306-0465.
MONTHLY DEPOSIT WORKSHEET
MONTHLY DEPOSIT WORKSHEET
Keep this worksheet for your records. Write your permit
Keep this worksheet for your records. Write your permit
number and filing period here. ___________________
number and filing period here. ___________________
5% State Sales Tax:
1. $ ___________________
5% State Sales Tax:
1. $ ___________________
+
+
Local Option Tax:
2. $ ___________________
Local Option Tax:
2. $ ___________________
+
+
School Local Option Tax: 3. $ ___________________
School Local Option Tax: 3. $ ___________________
=
=
DEPOSIT AMOUNT
4. $ ___________________
DEPOSIT AMOUNT
4. $ ___________________
PENALTY
5. $ ___________________
PENALTY
5. $ ___________________
INTEREST
6. $ ___________________
INTEREST
6. $ ___________________
TOTAL AMOUNT DUE
7. $ ___________________
TOTAL AMOUNT DUE
7. $ ___________________
MONTHLY DEPOSIT WORKSHEET
MONTHLY DEPOSIT WORKSHEET
Keep this worksheet for your records. Write your permit
Keep this worksheet for your records. Write your permit
number and filing period here. ___________________
number and filing period here. ___________________
5% State Sales Tax:
1. $ ___________________
5% State Sales Tax:
1. $ ___________________
+
+
Local Option Tax:
2. $ ___________________
Local Option Tax:
2. $ ___________________
+
+
School Local Option Tax: 3. $ ___________________
School Local Option Tax: 3. $ ___________________
=
=
DEPOSIT AMOUNT
4. $ ___________________
DEPOSIT AMOUNT
4. $ ___________________
PENALTY
5. $ ___________________
PENALTY
5. $ ___________________
INTEREST
6. $ ___________________
INTEREST
6. $ ___________________
TOTAL AMOUNT DUE
7. $ ___________________
TOTAL AMOUNT DUE
7. $ ___________________
QUARTERLY RETURN WORKSHEET
QUARTERLY RETURN WORKSHEET
Keep these worksheets for your records. Write your permit number
Keep these worksheets for your records. Write your permit number
and filing period here. _______________________________
and filing period here. _______________________________
1 Gross Sales (quarter)
1 Gross Sales (quarter)
2 Goods Consumed (quarter)
2 Goods Consumed (quarter)
3 Total (add lines 1 and 2)
3 Total (add lines 1 and 2)
4 Exemptions (from line 21) (quarter)
4 Exemptions (from line 21) (quarter)
5 Taxable Amount (line 3 minus line 4)
5 Taxable Amount (line 3 minus line 4)
6a State Tax (5% of line 5) (quarter)
6a State Tax (5% of line 5) (quarter)
6b Total Local Option Tax (quarter)
6b Total Local Option Tax (quarter)
6c Total School Local Option Tax (quarter)
6c Total School Local Option Tax (quarter)
7 Total Tax (add lines 6a, 6b, and 6c)
7 Total Tax (add lines 6a, 6b, and 6c)
8 Deposits and Overpayment Credits
8 Deposits and Overpayment Credits
9 Balance (line 7 minus line 8)
9 Balance (line 7 minus line 8)
10 Penalty (if applicable)
10 Penalty (if applicable)
11 Interest (if applicable)
11 Interest (if applicable)
12 Total Amount Due (add lines 9-11)
12 Total Amount Due (add lines 9-11)
QUARTERLY EXEMPTIONS WORKSHEET
QUARTERLY EXEMPTIONS WORKSHEET
13 Interstate Commerce
13 Interstate Commerce
14 Govt Units/Educ Inst
14 Govt Units/Educ Inst
15 Resale/Processing
15 Resale/Processing
16 Farm Machinery/Equip
16 Farm Machinery/Equip
17 Indust Mach, Equip, Comp
17 Indust Mach, Equip, Comp
18 New Construction
18 New Construction
19 Exempt Food/Drugs
19 Exempt Food/Drugs
20 Other:
20 Other:
Other:
Other:
Other:
Other:
21 Total Exemptions
21 Total Exemptions
31-089 rf04d 10/02
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