Form G-49 - General Excise/use Annual Return And Reconciliation
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1
2FORM G-49
STATE OF HAWAII — DEPARTMENT OF TAXATION
DO NOT WRITE IN THIS AREA
16
(Rev. 2017)
GENERAL EXCISE/USE
ANNUAL RETURN &
RECONCILIATION
X
Place an X in this box ONLY if this is an AMENDED return
99-99-99
GE-999-999-9999-99
TAX YEAR ENDING
HAWAII TAX I.D. NO.
1234
Last 4 digits of your FEIN or SSN
ID NO 99
TAXPAYER NAMEXXXXXXXXXXXXXXXXX
NAME:
Column a
Column b
Column c
BUSINESS
VALUES, GROSS PROCEEDS
EXEMPTIONS/DEDUCTIONS
TAXABLE INCOME
ACTIVITIES
OR GROSS INCOME
(Attach Schedule GE)
(Column a minus Column b)
PART I - GENERAL EXCISE and USE TAXES @ ½ OF 1% (.005)
X
999999999999
999999999999
999999999999
1. Wholesaling
1
X
999999999999
999999999999
999999999999
2. Manufacturing
2
X
999999999999
999999999999
999999999999
3. Producing
3
X
999999999999
999999999999
999999999999
4. Wholesale Services
4
5. Landed Value of
X
999999999999
999999999999
999999999999
Imports for Resale
5
6. Business Activities of
X
999999999999
999999999999
999999999999
Disabled Persons
6
X
999999999999
7. Sum of Part I, Column c (Taxable Income) — Enter the result here and on page 2, line 21, Column (a)
7
PART II - GENERAL EXCISE and USE TAXES @ 4% (.04)
X
999999999999
999999999999
999999999999
8. Retailing
8
X
9. Services Including
999999999999
999999999999
999999999999
Professional
9
X
999999999999
999999999999
999999999999
10. Contracting
10
X
11. Theater, Amusement
999999999999
999999999999
999999999999
and Broadcasting
11
X
999999999999
999999999999
999999999999
12. Commissions
12
13. Transient
X
999999999999
999999999999
999999999999
Accommodations Rentals
13
X
999999999999
999999999999
999999999999
14. Other Rentals
14
X
15. Interest and
999999999999
999999999999
999999999999
All Others
15
X
16. Landed Value of Imports
999999999999
999999999999
999999999999
for Consumption
16
X
999999999999
17. Sum of Part II, Column c (Taxable Income) — Enter the result here and on page 2, line 22, Column (a)
17
DECLARATION
- I declare, under the penalties set forth in section 231-36, HRS, that this return (including any accompanying schedules or statements) has been
examined by me and, to the best of my knowledge and belief, is a true, correct, and complete return, made in good faith for the tax period stated, pursuant to the
General Excise and Use Tax Laws, and the rules issued thereunder.
IN THE CASE OF A CORPORATION OR PARTNERSHIP, THIS RETURN MUST BE SIGNED BY AN OFFICER, PARTNER OR MEMBER, OR DULY AUTHORIZED AGENT.
SIGNATURE
TITLE
DATE
DAYTIME PHONE NUMBER
TITLEXXXXXXXX
99/99/99
(999) 999-9999
Continued on page 2 — Parts V & VI
MUST
be completed
16
Form G-49
(Rev. 2017)
G49_T 2017A 01
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