State Form 44469 - Sales And Use Tax - Indiana Department Of Revenue

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ST-103
0807
Sales and Use Tax
State form 44469 (rps)
.
,
,
Total Sales....................................................
1.
.
,
,
Exemptions/Deductions................................
2.
X
Authorized
.
Signature
,
,
Taxable Sales (line 1 −2).............................
3.
I declare under penalties of perjury that this is a true, correct and complete voucher.
S
.
,
,
Date
Phone # (
)
Total Tax Due (6% of line 3).......................
4.
.
,
,
Discount (Collection Allowance).................
5.
TRUST REGISTRATION
.
,
,
Use Tax Due (6% X Purchases)...................
6.
Taxpayer ID Number
For Tax Period
.
,
,
Interest Due (Line 4 + Line 6 x Int Rate)*..
7.
6100499916 902 8
FEB 2008
2008
7
*The
Annual Interest Rate is
%
.
,
,
Penalty Due...........................................
Filing Status
Due on or Before
8.
MONTHLY
MAR 31 2008
.
,
,
Payment Previously Made (EFT).................
9.
(2109108(
Amount Due
.
,
,
$
(Add Lines 4 + 6 + 7 + 8 minus 5 & 9)
10.
INDIANA DEPARTMENT OF REVENUE
P.O. Box 7218
INDIANAPOLIS, IN 46207-7218
(462077218184(
04610049991690205021022920080331200808

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