Iowa Retailer'S Use Tax Quarterly Return
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1
2
3IMPORTANT: You must file this deposit even
IOWA RETAILER'S USE TAX MONTHLY DEPOSIT
if you had no use tax activity this month. If no
activity, put zeroes in lines below.
s
s
Permit No.
Period
Date Due
5% State Tax:
1. $ ________________
+
Local Option Tax:
2. $ ________________
+
School Local Option Tax:
3. $ ________________
=
DEPOSIT AMOUNT
4. $ ________________
5. $ ______________ s
PENALTY
6. $ ______________ s
INTEREST
Date
Phone #
Signature of Retailer or Agent
7. $ ______________ s
TOTAL AMOUNT DUE
IMPORTANT: You must file this deposit even
IOWA RETAILER'S USE TAX MONTHLY DEPOSIT
if you had no use tax activity this month. If no
activity, put zeroes in lines below.
s
s
Permit No.
Period
Date Due
5% State Tax:
1. $ ________________
+
Local Option Tax:
2. $ ________________
+
School Local Option Tax:
3. $ ________________
=
DEPOSIT AMOUNT
4. $ ________________
5. $ ______________ s
PENALTY
6. $ ______________ s
INTEREST
Date
Phone #
Signature of Retailer or Agent
7. $ ______________ s
TOTAL AMOUNT DUE
If you had no sales in Iowa this quarter, put zeroes on lines 1
IOWA RETAILER'S USE TAX QUARTERLY RETURN
and 12.
32-019 rf20a (11/19/01)
s
1 Gross Sales in Iowa (quarter)
s
2 Goods Consumed in Iowa (quarter)
3 Total (add lines 1 and 2)
s
4 Exemptions (from line 21) (quarter)
5 Taxable Amount (line 3 minus line 4)
s
s
Permit No.
Period
Date Due
s
6a State Tax (5% of line 5) (quarter)
s
6b Total Local Option Tax (quarter)
s
6c Total School Local Option Tax (quarter)
7 Total Tax (add lines 6a, 6b, and 6c)
s
8 Deposits and Overpayment Credits
9 Balance (line 7 minus line 8)
s
10 Penalty (if applicable)
s
11 Interest (if applicable, see instructions)
Date
Title
s
Signature of Retailer or Agent
12 Total Amount Due (add lines 9-11)
Daytime Phone No.: ________________
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