Sales And Tax Return - City And County Of Broomfield Sales Tax Administration Division
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CITY & COUNTY OF BROOMFIELD
FILING PERIO D
TAX
___
,•
Sales Tax Administration Divisio n
P .O . Box 40 7
NOTE : You must file this return
B
fi ld Co 80038 0407
Retums not postmarked by
room e
,
-
even if line 15 is zero $
the due date will be late
If filing a Consolidated Return, OR advising of changes on
Due Date
State Sales Tax#
City License #
page 2, please place a LARGE X in box at right >>>>
6 . Excess Tax Collected
$
(See instructions )
7 . Sub-Total of Sales Taxes :
$
(Line 5 plus line 6 )
8 . Vendor Fee: (Line 7 multiplied by 3%)
$
( .03) Maximum$20 0
Enter -0- on Late Return s
Message :
9. Net Broomfield City and
$
County Sales Tax :
(Line 7 minus line 8 )
10 . Lodging Tax : Balance due from
$
Lodging Tax Return (Attach copy of return )
1 . GROSS SALES & SERVICES :
(Round to evenS)
II . FID/ALID TAX :
(Total receipts, before sales tax, from City &
Flatiron Improvement District (FID) or
$
County activity must be reported including all
,
4'
Arista Local Improvement District (ALID)
sales, rentals, leases, & services, both
Line 4 multiplied by .2% ( .002 )
taxable and non- taxable)
See Instruction s
Ia . ADD-Bad Debts Collected :
$
12 . Late Filing Penalty :
$
(which were previously deducted)
(See Instructions)
2. Adjusted Gross Sales &
$
13 . Interest :
$
Services : (Line 1 plus 1a)
(See Instructions )
3. Exemptions :
$
14 . Adjustments :
$
(Please insert total of Line 3,
(Attach Authorization Letter)
from page 2>
See Instruction s
4. Net Taxable Sales & Services :
$
15 . Total Due and Payable :
$
(Line 2 minus line 3)
(Add Line 9 through line 13) [!yjjjs 1 4
if credit is authorized ; Plus 14 if a
debit is reauired l
5 . Broomfield City and County
$
Make Check or Money Order Payable to :
Sales Tax : (Line 4 multiplied b y
4 .15%) ( .0415)
City
and County of Broomfiel d
(Continued on Line 6 )
Business Location
Phone : 303-464-5811 Fax : 303-410-380 2
Email :
salestaxbroomfield .org
Web :
www .broomfield .org/salesta x
My signature aft1rns that I have read this return and it IS true and correct to the best of my knowledge and is signed subject to penaltie s
for perjury and other criminal offenses.
Signature : _______________________________________________________________
Date :
Title :
Phone :
Fax :
Email :
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