Computation Of Tax Form - City Of Wheat Ridge Tax Division
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1CITY OF WHEAT RIDGE TAX DIVISION
c/o FirstBank Data Corp., PO Box 151654 Lakewood, CO 80215-8639 (303)235-2820
ONLINE PAY BY CARD: https://salestax.ci.wheatridge.co.us
ONLINE PAY BY VIRTUAL CHECK:
PERIOD
COVERED
DUE
DATE
ACCOUNT
NUMBER
COMPUTATION OF TAX
GROSS SALES
(TOTAL RECEIPTS FROM CITY ACTIVITY MUST BE REPORTED AND
1.
ACCOUNTED FOR IN EVERY RETURN INCL. ALL SALES, RENTALS, AND
AND SERVICE
5A. AMOUNT OF CITY SALES TAX:
LINE 4
X3%
LEASES AND ALL SERVICES BOTH TAXABLE AND NON-TAXABLE.)
2A. ADD: BAD DEBTS COLLECTED
2B.
TOTAL LINES 1 & 2A
NON-TAXABLE
(INCLUDED IN ITEM 1 ABOVE)
3.
A.
6.
ADD: EXCESS TAX COLLECTED
SERVICE SALES
B.
SALES TO OTHER LICENSED DEALERS
7.
ADJUSTED TAX
FOR PURPOSES OF TAXABLE RESALE
D
SALES SHIPPED OUT OF
(INCLUDED IN
C.
8.
DEDUCT VENDOR FEE: LESSER OF 2% OF LINE 7 OR $100.00
(
)
CITY AND / OR STATE
ITEM 1 ABOVE)
E
D.
BAD DEBTS
(ON WHICH CITY SALES
9.
TOTAL TAX (ITEM 7 MINUS 8)
CHARGED OFF
TAX HAS BEEN PAID)
D
E.
10. CITY USE TAX - AMOUNT SUBJECT TO TAX:
X3%
TRADE-INS FOR TAXABLE RESALE
U
F.
11. TOTAL TAX DUE: (ADD LINES 9 & 10)
SALES OF GASOLINE AND CIGARETTES
C
10% OF LINE 11
ENTER
SALES TO GOVERNMENTAL, RELIGIOUS
G.
12.
A.
LATE FILING
PENALTY:
TOTAL
AND CHARITABLE ORGANIZATIONS
T
OR $15 MIN.
IF RETURN IS FILED
ADD:
1.0% OF
INTEREST
H.
B.
RETURNED GOODS
AFTER DUE DATE THEN
I
LINE 11
PER MONTH:
I.
13. TOTAL TAX PENALTY AND INTEREST DUE: (ADD LINES 11 AND 12)
O
PRESCRIPTION DRUGS/PROSTHETIC DEVICES
N
J.
13A. LICENSE RENEWAL FEE DUE JANUARY 31 OR FINE MAY BE IMPOSED
FOOD STAMPS
S
K.
14.
A - ADD:
DEBIT
+
ADJUSTMENT PRIOR PERIODS
OTHER DEDUCTIONS (LIST)
ATTACH COPY OF OVER OR
L.
B - DEDUCT: (not for refund claim) CREDIT -
UNDERPAYMENT NOTICE -
3. TOTAL DEDUCTIONS
(TOTAL OF LINES 3A THRU 3L)
MAKE CHECK OR MONEY ORDER PAYABLE TO:
15. TOTAL AMOUNT DUE
(LINE 2B MINUS
CITY OF WHEAT RIDGE
4.
TOTAL CITY NET TAXABLE SALES & SERVICE
TOTAL LINE 3)
SCHEDULE A - SPECIAL MESSAGE FROM/TO TOWN
SCHEDULE - B - CITY USE TAX
NEW BUSINESS DATE
1. If ownership has changed, give the date of change and the new owner’s name.
MO.
DAY
YR.
The use tax ordinance (WRMC 22-68) imposes a tax equal to the rate shown on Line 5A upon the privilege of using, storing,
2. If business has been permanently discontinued, give date discontinued.
distributing or otherwise consuming in the City tangible personal property and select services purchased, rented or leased.
3. If business location has changed, give new address.
DATE OF
NAME OF VENDOR
TYPE OF COMMODITY
PURCHASE
DISCONTINUED DATE
4. Records are kept at what address?_________________________________________
PURCHASE
ADDRESS
PURCHASED
PRICE
MO.
DAY
YR.
5. If business is temporarily closed, give dates to be closed.
(A) LIST OF ALL PURCHASES (IF ADDITIONAL SPACE IS NEEDED - ATTACH SCHEDULE IN SAME FORMAT)
6. If business is seasonal, give months of operation.
$
(B) TOTAL PURCHASE PRICE OF PROPERTY SUBJECT TO CITY USE TAX
$
ENTER TOTAL LINE (B) ON LINE 10 ON TOP OF RETURN
SHOW BELOW CHANGE OF OWNERSHIP AND/OR
I, hereby certify, under penalty of perjury, that the statements
ADDRESS, ETC.
made herein are to the best of my knowledge true and correct.
City Hall
BY:______________________________________________
7500 W. 29th Ave.
COMPANY: ______________________________________
Wheat Ridge, CO 80033
PHONE:
________________________________________
__________________________________________________
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TITLE
DATE
BUSINESS ADDRESS
MAILING ADDRESS
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