Form 11 - Wyoming Vendor Sales/use Tax Return - Department Of Revenue
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1Wyoming Vendor Sales/Use Tax Return
Wyoming Vendor Sales/Use Tax Return
Department of Revenue
Department of Revenue
Herschler Bldg., 122 W. 25th St.
Herschler Bldg., 122 W. 25th St.
11
11
Cheyenne, WY
Cheyenne, WY
82002-0110
82002-0110
Form
Form
Statewide Report for Multiple Locations
Statewide Report for Multiple Locations
Department
Use ONLY
Ownership
Ownership
This Tax Return & Payment MUST BE POSTMARKED
This Tax Return & Payment
MUST BE POSTMARKED
on or before the following date to avoid late
on or before the following date to avoid late
RID:
Name:
penalties and interest:
penalties and interest:
License
PLEASE PRINT CLEARLY - USE BLACK INK
Report Period:
through
No. :
USE NO PUNCTUATION
( commas, decimals, or $ )
.
1. Gross sales and
taxable services
.
2. Total deductions
.
3. Net taxable sales
(Line 1 minus Line 2)
4.
Sales Tax Collected This Report Period:
Please write neatly inside the boxes!
Please write neatly inside the boxes!
Tax
Tax
Sales Tax
Sales Tax
Use Tax owed on
Use Tax owed on
Tax
Tax
Sales Tax
Sales Tax
Use Tax owed on
Use Tax owed on
4 A.
4 A.
4 A.
4 A.
4 B.
4 B.
4 B.
4 B.
County
County
County
County
Rate
Rate
Collected
Collected
Vendor's Purchases
Vendor's Purchases
Rate
Rate
Collected
Collected
Vendor's Purchases
Vendor's Purchases
.
.
.
.
Natrona
Albany
.
.
.
.
Big Horn
Niobrara
.
.
.
.
Park
Campbell
.
.
.
.
Carbon
Platte
.
.
.
.
Sheridan
Converse
.
.
.
.
Sublette
Crook
.
.
.
.
Sweetwater
Fremont
.
.
.
.
Teton
Goshen
.
.
.
.
Uinta
Hot Springs
.
.
.
.
Washakie
Johnson
.
.
.
.
Laramie
Weston
.
.
Lincoln
.
.
F
4C. Enter Totals For Columns 4A and 4B here,
then add them and place sum on Line 4D.
.
4D. Total combined Sales and Use Tax (sum from line 4C.)
(sum from line 4C.)
enter amount at right ---->
.
5. Excess Tax Collected
enter amount at right
---->---->---->---->---->---->---->---->
.
6. TOTAL TAX DUE (Lines 4D + 5)
(Lines 4D + 5)
enter amount at right
---->---->---->---->---->
.
7. Adjustments (from line 7 on your worksheet)
(from line 7 on your worksheet)
enter amount at right
---->---->---->---->
PAY THIS
PAY THIS
F
.
8. TOTAL DUE
TOTAL DUE
(Lines 6+ 7 )
(Lines 6+ 7 )
---->---->---->---->---->---->---->---->
AMOUNT
AMOUNT
R e v i s e d 1 0 / 0 0
R e v i s e d 1 0 / 0 0
I declare, under penalty of perjury, that I have examined this return and to the best of my knowledge and belief it is correct and complete.
3RD Party Form
3RD Party Form
Authorized
,
Return this
Return this
Signature
Title
original form
original form
Date:
/
/
Phone No. (
)
-
to Department
to Department
If your address has changed, 4 4 appropriate box:
of Revenue
of Revenue
Business Location
Mailing Address
Both
New Address:
Has your business permanently closed? Date effective ___/___/_____ (License will be canceled)
Has there been a change in ownership? Date effective ___/___/_____ (License will be canceled)
(For ownership change, please provide name(s) and address of new owner(s) below:
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