Form O7 - Combined Excise Tax Return - 2002
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5MAIL TO: State of Washington
JULY 2002
Department of Revenue
PO Box 34051
07
Seattle, WA 98124-1051
COMBINED EXCISE TAX RETURN
02
ONLY Fill in Box if Amended Return Information Attached
"
NAME
REG NO.
FIRM NAME
STREET ADDRESS
CITY, STATE, ZIP
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"
"
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Address Changes?
business location
mailing address
both
Business closed?
Date closed ___/___/___ See note section, pg 2.
Please fill in the appropriate box and note address changes above.
I STATE BUSINESS AND OCCUPATION TAX
Line
Column I
Col. 2 Deductions*
Column 3
Col. 4
Column 5
Tax Classification
Code
No.
Gross Amount
Totals from Pg. 3 & 4
Taxable Amount
Rate
Tax Due
1
16
Extracting, Extracting for Hire
.00484
Slaughter, Break Proc, Perish Meat-Whlse; Mfg Wheat
2
30
.00138
into Flour; Raw Seafood; Soybean & Canola Proc
Travel Agent Com/Tour Operators; Intl Charter Freight
3
28
.00275
Brokers; Stevedoring
4
Insurance Agents; Insurance Brokers Commis
14
.00484
Manuf Fresh Fruit and Veg; Split or Proc Dried Peas;
5
21
.00138
Prescription Drug Warehousing; Mfg Dairy Products
6
Processing for Hire; Printing and Publishing
10
.00484
7
Manufacturing
07
.00484
8
80
.00484
Royalties; Child Care
9
03
.00484
Wholesaling
Warehousing; Radio & TV Broadcasting; Public Road
10
11
.00484
Construction; Government Contracting
11
Public or Nonprofit Hospitals
55
.015
Cleanup of Radioactive Waste for US Gov’t;
12
83
.00471
Environmental Remedial Action
13
04
.015
Service & Other Activities
14
Retailing of Interstate Transportation Equip
19
.00484
15
Retailing
02
.00471
* Deductions taken but not itemized on pages 3 and 4 will be disallowed.
TOTAL B&O TAX
GROSS AMOUNTS FOR RETAILING AND
RETAIL SALES MUST BE THE SAME
II STATE SALES AND USE TAX
Retail Sales (also complete local tax section III)
16
01
.065
Use Tax/Deferred Sales Tax (also complete
Value of articles used by taxpayer as a consumer
17
05
.065
on which no Washington sales tax has been paid
local tax section III)
TOTAL STATE SALES & USE TAX
III LOCAL CITY AND/OR COUNTY SALES AND USE TAX
25
DUE DATE: AUGUST 25, 2002
AUGUST 2002
Local Sales Tax (Enter applicable rate of tax)
Code 45
S
M
T
W
T
F
S
!
5 % Penalty Assessed After August 26, 2002
Total Taxable Amount must be the same as line 16, column 3, Taxable Amount
1
2
3
10% Penalty Assessed After September 30, 2002
Line
4
5
6
7
8
9
10
No. Location Code
Taxable Amount
Local Rate
Tax Due City or Co.
20% Penalty Assessed After October 31, 2002
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12
13
14
15
16
17
If the due date falls on a weekend or legal holiday,
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21
22
23
24
18
the due date is extended to the next business day.
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26
27
28
29
30
31
19
#
4
Please fill in this box if you had no business activity.
(see note section, pg. 2)
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4
This return must be mailed, unless filed electronically.
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4
Please make check or money order payable to the Washington State
Department of Revenue. Do not send cash or coins.
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For assistance, call (800) 647-7706.
TOTAL
TOTAL
TAXABLE
4
Signature
Local Use Tax/Deferred Sales Tax (Enter applicable rate of tax)
Code 46
Ph. (
)
4
Date
Total Value of Articles must be the same as line 17, column 1, Gross Amount
Line
Line
No. Location Code
Value of Articles
Local Rate Tax Due City or Co.
Item
VIII TOTALS
No.
23
29
Total All Tax Due from page 1
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30
Total All Tax Due from page 2
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31
Rental Car Tax (attach Rental Car Tax Addendum)
TOTAL VALUE
TOTAL
OF ARTICLES
32
Subtotal (add lines 29-31)
Line
Tax
33
Credit (from page 2, section VII, total credit)
Code
Taxable Amount
Rate
Tax Due
No.
Classification
34
Subtotal (subtract line 33 from line 32)
Region Transit
26
89
.004
Authority (RTA)
!
Minimum
35
Add Penalty, if applicable
$5.00
King County
27
90
.005
36
Interest
Food & Bev
28
36
TOTAL AMOUNT OWED
(add lines 34 - 36)
Litter Tax
.00015
402406070201
"
!
Penalty waiver request? Attach and fill in box.
(see note section, pg 2)
(6-21-02)
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