Form 14 - Wyoming Consumer Sales & Use Tax Remittance Form

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Form 14
Wyoming Consumer Sales & Use Tax Remittance Form
Wyoming Department of Revenue
Excise Tax Division
(307) 777-5213
Revenue ID (RID) Number: (Dept. Assigned)______________________
Name and
Report Period:
through
Address (below):
Important Notice!
Wyoming sales tax is due on all purchases of tangible personal property
made in this state.
Wyoming use tax is due on all purchases of tangible personal property
made outside the state for storage, use, or consumption within this state.
All Wyoming residents, including contractors working in Wyoming, are
subject to the sales/use tax provisions of Title 39.
Please provide the following information:
Tax is due the end of the month following the month of purchase.
A. Purchase Month/Year: ________________________
B. Description of goods purchased: __________________________________________________________________________________
C. Location of purchase(s) (City, State, County): ________________________________________________________________________
D. Goods were shipped to me by
common carrier, or postal service:
Yes:
No:
1. Purchase price of goods: ..........................................................................................................
$
2. Amount of Tax Due: (your WY county tax rate ______ % X Line 1)..........................................
$
3. Tax paid at time of purchase(s): ................................................................................................
$
4. Total Tax Due: (Subtract line 3 from line 2) .............................................................................
$
(Tax is due the end of the month following the month of purchase)
5. Penalty ........................................................................................................................................
(see instructions)
$
6. Interest ........................................................................................................................................
$
(see instructions)
7. Total Due: (Add lines 4, 5, & 6) ...............................................................................................
$
Affidavit of Authenticity:
I understand that by signing this return I affirm all information shown is true and correct to the best of my knowledge.
Signature of Purchaser: _________________________________________________ Date:_________________________
Social Security Number: _____________________________ Phone: _________________________________________
Return this form and your payment of Line 7 to:
Make your check payable to:
Wyoming Department of Revenue
Excise Tax Division, Consumer Tax
"Wyoming Department of Revenue"
122 West 25th Street
Cheyenne, Wyoming 82002-0110
Form ETS-14 Revised 8/97

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