Combined Excise Tax Return - September 2000

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State of Washington
09
Department of Revenue
SEPTEMBER 2000
PO Box 34051
Seattle, WA 98124-1051
00
COMBINED EXCISE TAX RETURN
Fill in Box if Amended/Supplemental Return or Correspondence is Attached
NAME
REG NO.
FIRM NAME
STREET ADDRESS
CITY, STATE, ZIP
Make any address changes above. Fill in box if this change is
If your business closed, fill in the box
and
your
business location,
mailing address, or
both.
I STATE BUSINESS AND OCCUPATION TAX
indicate date:___/___/____. See note 5, page 2.
Line
Column I
Col. 2 Deductions*
Column 3
Col. 4
Column 5
Tax Classification
Code
No.
Gross Amount
Totals from Pg. 3 & 4
Taxable Amount
Rate
Tax Due
1
Extracting, Extracting for Hire
16
.00484
Slaughter, Break Proc, Perish Meat-Whlse, Mfg Wheat
2
30
.00138
into Flour, Raw Seafood, Soybean & Canola Proc
Travel Agent Com; Intl Charter Freight Brokers and
3
28
.00275
Stevedoring
4
Insurance Agents/Insurance Brokers Commis
14
.00484
5
Manuf Fresh Fruit and Veg; Split or Proc Dried Peas
21
.00138
6
Processing for Hire/Printing and Publishing
10
.00484
7
Manufacturing
07
.00484
8
Royalties; Child Care
80
.00484
9
03
.00484
Wholesaling
Warehousing, Radio & TV Broadcasting, Public Road
10
11
.00484
Construction/Government Contracting
11
Public or Nonprofit Hospitals
55
.015
Cleanup of Radioactive Waste for US Gov’t;
12
83
.00471
Environmental Remedial Action
13
04
.015
Service & Other Activities
14
Retailing of Interstate Transportation Equip
19
.00484
15
Retailing
02
.00471
* Deductions taken but not itemized on pages 3 and 4 will be disallowed.
TOTAL B&O TAX
GROSS AMOUNTS FOR RETAILING AND
II STATE SALES AND USE TAX
RETAIL SALES MUST BE THE SAME
16
Retail Sales (also complete local tax section III)
01
.065
Value of articles used by taxpayer as a consumer
17
Use Tax (also complete local tax section III)
.065
05
on which no Washington sales tax has been paid
III LOCAL CITY AND/OR COUNTY SALES AND USE TAX
TOTAL STATE SALES & USE TAX
Local Sales Tax (Enter applicable rate of tax)
Code 45
OCTOBER 2000
DUE DATE: OCTOBER 25, 2000
Total Taxable Amount must be the same as line 16, column 3, Taxable Amount
S
M
T
W
T
F
S
5% Penalty is Due After October 25, 2000
25
Line
1
2
3
4
5
6
7
No. Location Code
Taxable Amount
Rate
Tax Due City or Co.
10% Penalty is Due After November 30, 2000
8
9
10
11
12
13
14
20% Penalty is Due After January 2, 2001
18
15
16
17
18
19
20
21
If the due date falls on a weekend or legal holiday,
22
23
24
25
26
27
28
19
the due date is extended to the next business day.
29
30
31
20
Please fill in this box if you had no business activity.
(See note 6 page 2)
21
This return must be filed even if no tax is due.
22
Please make check or money order payable to the
Washington State Department of Revenue. Do not send
TOTAL
TAXABLE
TOTAL
cash or coins.
For assistance, call (800) 647-7706.
Local Use Tax (Enter applicable rate of tax)
Code 46
Total Value of Articles must be the same as line 17, column 1, Gross Amount
Signature
Line
Ph. (
)
No. Location Code
Value of Articles
Rate
Tax Due City or Co.
Date
23
Line
Item
VIII TOTALS
No.
24
Total All Tax Due from page 1
29
25
Total All Tax Due from page 2
30
TOTAL VALUE
TOTAL
OF ARTICLES
31
Rental Car Tax (attach Rental Car Tax Addendum)
Line
Tax
32
Subtotal (add lines 29-31)
Code
Taxable Amount
Rate
Tax Due
No.
Classification
33
Credit (from page 2, section VII, total credit)
Region Transit
26
89
.004
Authority (RTA)
34
Subtotal (subtract line 33 from line 32)
King County
Minimum
27
90
.005
Penalty
35
$5.00
Food & Bev
36
Interest
28
Litter Tax
36
.00015
TOTAL AMOUNT OWED (ADD LINES 34 - 36)
REV 40 2406 SEPT00 (07-17-00)
If you qualify, attach penalty waiver request and fill in this box
(See note number 4 on page 2)
Page 1
.

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