Form Et-1 Sample - Arkansas Excise Tax Return
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30-L1795282944 rtL001
Arkansas Excise Tax Return
ET-1 Form
S A M P L E O N L Y
ACCOUNT ID
12244001-SLS
:
ARKANSAS SAMPLE TAX RETURN
PERIOD ENDING: 31-Jul-2009
SAMPLE ONLY STREET
DUE ON OR BEFORE: August 20, 2009
SAMPLETOWN AR 72203
Check box and attach a detailed explanation and
Amended Return
supporting documentation for amending the return.
Use whole dollars only.
Use blue or black ink only.
Gross Receipts Tax
A
B
C
D
E
F
Taxable Sales
Rate
Gross Tax Due
2% Discount
Tourism Credit
Net Tax Due
(Sales by In-State Sellers)
1. State Tax
6.000%
2.
Food Tax
2.000%
3.
Mfg. Utility Tax
3.250%
»»»»»»»»»»»»»»
4.
Aviation Tax
6.000%
»»»»»»»»»»»»»»
Vendor Use Tax
A
B
C
Rate
Net Tax Due
Taxable Sales
(Sales by Out-of-State Sellers)
6.000%
5.
State Tax
»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»
2.000%
6.
Food Tax
»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»
3.250%
7.
Mfg. Utility Tax
»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»
6.000%
8.
Aviation Tax
»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»»
Consumer Use Tax
A
S A M P L E O N L Y
B
C
D
E
Taxable Purchases
Rate
Gross Tax Due
Economic Dev Credit
Net Tax Due
(Purchases by All Taxpayers)
6.000%
9.
State Tax
2.000%
10.
Food Tax
11.
Mfg. Utility Tax
3.250%
6.000%
12.
Aviation Tax
31. Total State Tax
........................
I DECLARE THIS RETURN (INCLUDING ANY ACCOMPANYING SCHEDULES)
(add Net Tax Due for lines 1 thru 12)
HAS BEEN EXAMINED BY ME, AND TO THE BEST OF MY KNOWLEDGE
AND BELIEF IS TRUE, CORRECT AND COMPLETE.
Total Special & Alcoholic Beverage Taxes
....
32.
(from line 23)
SIGN
HERE
Total Local Tax
33.
.................................................
(from line 30)
Owner, Partner or Corporate Officer
PRINT
Total Tax Due
......................................
34.
(add lines 31, 32, and 33)
HERE
Contact Person
Less Prepayments
.............................................
35.
(if required)
Net Tax Due
.......................
36.
(enter this amount on the voucher below)
Date
Phone Number
Do Not Remove Voucher.
Department of Finance & Administration
0-L1795282944 rtL001
Taxpayer Name: ARKANSAS SAMPLE TAX
Payment Voucher
RETURN
Make your check payable to “Department of Finance &
Administration”. Write your Account ID on the check. Please
mail return and voucher with payment to the address
Account ID:
12244001-SLS
below:
Period Ending:
31-Jul-2009
S A M P L E O N L Y
DEPARTMENT OF FINANCE &
Amount Paid:
ADMINISTRATION
P.O. BOX 3861
$
LITTLE ROCK, AR 72203-3861
SLSACC12244001SLS07312009RTNPYM00000000000000000000000
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