Multi-Purpose Tax Return - City Of Bellevue - 2017
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4City of Bellevue
MAIL TAX RETURNS TO:
Q
LOCKBOX
MULTI-PURPOSE TAX RETURN
PO BOX 34372
17
SEATTLE, WA 98124-1372
For more information contact:
Check
Date Due
Reporting Period
Registration #
CITY OF BELLEVUE
Digit
Tax Division
PO Box 90012
Bellevue, WA 98009-9012
o Check this box if there are account changes and/or updates.
Please note the changes on the back of this form.
Go Green. File on-line at
https://
and we will stop sending
you paper returns. A user and service fee may apply.
Section 1 Business & Occupation Tax - GROSS RECEIPTS
Line
Column 1
Code
Column 2
Column 3
Column 4
Column 5
Column 6
Tax Classification
No.
Gross Receipts
Deductions*
Taxable Receipts
Tax Rate
Tax Due
No.
1
Wholesaling
02
0.001496
2
Retailing/Retail Services
03
0.001496
3
Service & Other (Not apportioned)
06
0.001496
4
Service & Other (Apportioned) *
12
Carryover from Schedule A
0.001496
5
Manufacturing/Processing for Hire
01
0.001496
6
Printing/Publishing
04
0.001496
7
Extracting/Extracting for Hire
11
0.001496
8
Less Multiple Activities Tax Credit*
20
Carryover from Schedule C
(
)
9
Enter Taxable Receipts Sub-Total Here
Sub-Total
(If taxable receipts are less than or equal to $40,000 then no GROSS RECEIPTS TAX is due)
Section 2 Business & Occupation Tax - SQUARE FOOTAGE
10
Square Footage*
08
Carryover from Schedule B
0.2440875
(If taxable square footage is less than or equal to 250 square feet then no SQUARE FOOTAGE tax is due)
Section 3 Utility Taxes
11
Telephone
40
0.060
12
Cellular
41
0.060
13
Gas
42
0.050
14
Light & Power
43
0.050
15
Cable TV
44
0.048
16
Water
45
0.104
17
Solid Waste
46
0.045
18
Sewer
47
0.050
19
Storm Drainage
48
0.050
20
Utility Tax Sub-Total - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Sub-Total
Section 4 Other Taxes
21
Amusement Games
60
0.020
22
Pull Tabs/Punch boards
61
0.050
23
Bingo
62
0.050
24
Raffles
63
0.050
25
Admission Charges
64
0.030
Other Tax Sub-Total - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Sub-Total
Tax Sub-Totals
*Schedules are required for deductions and credits.
Account Balance
Penalties - (see back)
Name
___________________________________________________
(please print)
Interest - (see back)
Total Due
Title ______________________________________________________________
Please make checks payable to the City of Bellevue
Phone ____________________________________________________________
I hereby certify that the statements and information provided on this tax return are true and complete to the best of my knowledge.
Signature
Date
Phone: 425-452-6851 • FAX: 425-452-6198 • tax@bellevuewa.gov
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