Sales/use Tax Return Form - City Of Westminster

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TAXPAYER'S NAME AND ADDRESS
CITY OF WESTMINSTER
PERIOD
ACCOUNT
SALES/USE TAX RETURN
COVERED
NUMBER
DUE
DATE
Mail Completed Return with Payment to:
P.O. Box 17107
Denver, CO 80217-7107
(303) 658-2065 
COMPUTATION OF TAX
GROSS SALES
TOTAL RECEIPTS FROM CITY ACTIVITY MUST BE REPORTED AND
1.
5.
AMOUNT OF CITY SALES TAX 3.85% OF LINE 4
ACCOUNTED FOR IN EVERY RETURN INCL. SALES RENTALS AND LEASES AND ALL
AND SERVICE
SERVICES BOTH TAXABLE AND NON-TAXABLE
2A. ADD: BAD DEBTS COLLECTED
6.
ADD: EXCESS TAX COLLECTED
2B. TOTAL LINES 1 & 2A
7.
TOTAL CITY SALES TAX (ADD LINES 5 & 6)
CITY USE TAX
NON-TAXABLE SERVICE SALES
(FROM SCHEDULE B)
3.
A.
8.
(INCLUDED IN ITEM 1 ABOVE)
AMOUNT SUBJECT TO TAX ______________________ x 3.85% =
SALES TO OTHER LICENSED DEALERS
B.
9.
TOTAL TAX DUE (ADD LINES 7 & 8)
FOR PURPOSES OF TAXABLE RESALE
SALES SHIPPED OUT OF CITY AND/OR STATE
PENALTY
LATE FILING
C.
(INCLUDED IN ITEM 1 ABOVE)
IF RETURN IS FILED
▼ TOTAL PENALTY & INTEREST ▼
10% OF TAX ($15 MIN)*
10.
AFTER DUE DATE
BAD DEBTS CHARGED OFF
INTEREST
D.
D
ADD:
(ON WHICH CITY SALES TAX HAS BEEN PAID)
1%
PER MONTH
E
MAKE CHECK OR MONEY
E.
TRADE-INS FOR TAXABLE RESALE
D
11.
TOTAL DUE AND PAYABLE
ORDER PAYABLE TO
U
F.
SALES OF GASOLINE AND CIGARETTES
CITY OF WESTMINSTER
C
SALES TO GOVERNMENT AND
G.
* SPECIAL PENALTY APPLIES AFTER 3RD LATE RETURN
T
CHARITABLE ORGANIZATIONS
I
H.
RETURNED GOODS
O
PRESCRIPTION DRUGS AND
I.
SIGNATURE REQUIRED ON BOTTOM OF FORM
N
PROSTHETIC DEVICES
S
J.
K.
SPECIAL MESSAGE TO CITY FROM TAXPAYER
SCHEDULE A
L.
_______ CHECK HERE FOR BUSINESS CLOSURE/CHANGE OF OWNERSHIP
3. TOTAL DEDUCTIONS (TOTAL OF LINES 3 A THROUGH L)
_______ CHECK HERE FOR CHANGE OF ADDRESS
4. TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2B LESS LINE 3)
COMPLETE THE BOTTOM PORTION IF ANY OF THE ABOVE APPLY. ALWAYS SIGN BOTTOM OF FORM
SCHEDULE B - CITY USE TAX
THE WESTMINSTER MUNICIPAL CODE IMPOSES A TAX UPON THE PRIVILEGE OF USING, STORING, DISTRIBUTING, OR OTHERWISE
CONSUMING IN THE CITY TANGIBLE PERSONAL PROPERTY OR TAXABLE SERVICES PURCHASED RENTED OR LEASED.
PURCHASE
VENDOR NAME
TYPE OF COMMODITY
PURCHASE
DATE
ADDRESS
PURCHASED
PRICE
ENCLOSE ADDITIONAL SHEETS IN SAME FORMAT IF NEEDED
TOTAL PURCHASE PRICE OF PROPERTY & SERVICES SUBJECT
TO CITY USE TAX (ENTER ON LINE 8 ABOVE)
CLOSURE/OWNERSHIP CHANGE DATES
NEW OWNERSHIP/ADDRESS CHANGE INFORMATION:
TAXPAYER SIGNATURE (REQUIRED)
I HEREBY CERTIFY, UNDER PENALTY OF PERJURY, THAT THE STATEMENTS
MADE HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
____________________________________________
MO
DAY
YR
NEW BUSINESS
START DATE
BY:
____________________________________________
MO
DAY
YR
DISCONTINUED
TITLE:
____________________________________________
BUSINESS DATE
PHONE:
DATE:
BUSINESS ADDRESS MAILING ADDRESS
IMPORTANT REMINDERS:
1. INCLUDE WESTMINSTER ACCOUNT NUMBER, NAME, AND ADDRESS IN THE UPPER LEFT.
2. INCLUDE THE PERIOD FOR WHICH YOU ARE FILING.
Revised for Tax Periods
3. THE DUE DATE IS THE 20TH OF THE MONTH FOLLOWING THE END OF THE REPORTING PERIOD.
beginning on or after
4. YOUR WESTMINSTER ACCOUNT NUMBER IS NOT YOUR FEIN # OR YOUR STATE OF COLORADO
DEPARTMENT OF REVENUE ACCOUNT NUMBER.
January 1, 2011
5. IF YOU HAVE RECENTLY APPLIED FOR A WESTMINSTER ACCOUNT NUMBER, WRITE "APPLIED FOR"
AND THE APPLICATION DATE IN THE ACCOUNT NUMBER AREA.
6. ZERO LIABILITY RETURNS MAY BE FAXED TO (303) 706-3923 (PRIOR TO THE DUE DATE) OR
FILED ELECTRONICALLY AT IF YOU FILE ELECTRONICALLY OR FAX
A RETURN, DO NOT MAIL A COPY.
7. A RETURN IS REQUIRED EVEN IF NO TAX IS DUE. LATE RETURNS ARE SUBJECT TO PENALTY.

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