Form Tc-685 - Mining Severance Tax Annual Return

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Utah State Tax Commission
TC-685
Mining Severance Tax
Rev. 5/02
Annual Return
Utah State Tax Commission, 210 N 1950 W, Salt Lake City, Utah 84134-2400
Telephone (801) 297-4600
Taxpayer Name and Address
Report Period
Due date
Mining account number
Mine name and location
Metalliferous mineral mined
BERYLLIUM
Value
Quantity
$
1. Beryllium metal or concentrates sold or stockpiled
2. Less exemption of $50,000 (if metal reported is a by-product, enter 0)
$
3. Adjusted gross value (line 1 less line 2)
$
4. Taxable value (multiply line 3 by .20)
$
OTHER METALS OR CONCENTRATES
Quantity
$
5. Metal or concentrates sold or stockpiled, except beryllium
6. Less exemption of $50,000 (if metal reported is a by-product, enter 0)
$
7. Adjusted gross value (line 5 less line 6)
$
8. Taxable value (multiply line 7 by .30)
$
ORE
Quantity
$
9. Ore of all metals sold or stockpiled
10. Less exemption of $50,000
$
11. Adjusted gross value (line 9 less line 10)
$
12. Taxable value (multiply line 11 by .80)
$
TOTAL
$
13. Total taxable value (add lines 4, 8, and 12)
14. Mining severance tax (multiply line 13 by .026)
$
15. Quarterly prepayments
1st) _______________ 2nd) _______________
$
3rd) _______________ 4th) _______________
16. Tax Due
$
Penalties and interest will be computed as provided by law and billed by the Utah State Tax Commission for late filing and/or late payment.
I have reviewed this report and certify the information to be accurate and complete.
Date signed
Telephone number
Authorized signature

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