Combined Excise Tax Return - September 2000 Page 2
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4IV LODGING TAXES
TRANSIENT RENTAL INCOME INFORMATION
(Enter Location Code and Income Only)
Code 47
Line
Location Code
Income
Location Code
Income
Location Code
Income
No.
37
38
CONVENTION AND TRADE CENTER TAX
SPECIAL HOTEL/MOTEL TAX
Code 48
Code 70
Line
Line
Taxable Amount
Rate
Tax Due
Location Code
Taxable Amount
Rate
Tax Due
Location Code
No.
No.
39
42
40
43
41
44
TOTAL CONVENTION & TRADE CENTER TAX
TOTAL SPECIAL HOTEL/MOTEL TAX
V STATE PUBLIC UTILITY TAX
Line
Column I
Col. 2 Deductions*
Column 3**
Col. 4
Column 5
Tax Classification
Code
No.
Gross Amount
Totals from Pg. 4
Taxable Amount
Rate
Tax Due
45
Water Distribution
60
.05029
46
Sewer Collection
61
.03852
47
Power
49
.03873
48
Gas Distribution, Telegraph
26
.03852
49
Motor Transportation, Railroad, Railroad Car
08
.01926
50
Urban Transportation/Vessels Under 65 ft
12
.00642
51
Other Public Service Business
13
.01926
** If taxable amounts on lines 45-51 column 3 total less than $2,000, no Public Utility Tax is due.
TOTAL STATE PUBLIC UTILITY TAX
VI OTHER TAXES
Line
Column I
Col. 2 Deductions*
Column 3
Col. 4
Column 5
Tax Classification
Code
No.
Gross Amount
Totals from Pg. 4
Taxable Amount
Rate
Tax Due
52
Tobacco Products
20
.7490
53
Refuse Collection
64
.036
54
Petroleum Tax
57
Temporarily Not Due - Fund Limit Reached
.005
55
Hazardous Substance
65
.007
* Deductions taken but not itemized on page 4 will be disallowed.
Line
Tax Classification
Code
Item
Quantity Sold
Rate
Tax Due
No.
Number of Stoves, Fireplaces, & Solid Fuel
56
Solid Fuel Burning Device Fee
59
$30.00
Burning Devices:
57
Syrup Tax
54
Number of Gallons:
$1.00
58
State Enhanced 911 Tax
93
Number of Taxable Switched Access Lines:
.20
TOTAL OTHER TAXES
(Add lines 52-58)
NOTE:
VII CREDITS
1. If you do not have deductions, do not return pages 3 and 4.
Line
Credit
Credit Classification
Amount
I.D.
No.
2. If you have deductions, complete and return pages 3 and 4.
59
800
Multiple Activities Tax Credit (attach Schedule C)
3. LOCAL CITY AND/OR COUNTY SALES AND USE TAX. For your
High Technology Credit
convenience, a copy of the Local City and/or County Sales and Use
60
830
(attach Research & Development Credit Affidavit)
Tax supplemental form is provided in the “Business Tax Guide.” If
more space is required, you may make copies of this form or attach
Manufacturing Software/Programming Rural
61
860
additional local tax information in the same format.
Employment B&O Credit
4. For more information about the penalty waiver criteria, please call
62
865
Help Desk Services B&O Credit
Tax Express at (800) 334-8969, enter code 429.
63
Alternatives to Field Burning B&O Credit
875
5. For more information about business closures, please call
Tax Express at (800) 334-8969, enter code 430.
64
855
International Services Credit
6. If you would like to file “No Business Activity” by telephone, please
65
815
Small Business B&O Tax Credit (see table enclosed)
call our toll-free number (800) 647-7706.
Electric Utility Rural Economic Development
66
870
Revolving Fund Public Utility Tax Credit
7. To inquire about the availability of this form in an alternate format for
the visually impaired, please call (360) 753-3217. Teletype (TTY)
67
801
Bad Debt Tax Credit (attach Schedule B)
users may call (800) 451-7985.
68
805
Hazardous Substance
8. Need Help? If you need further information, please refer to the,
“Business Tax Guide”, or call the Department of Revenue office
69
810
Other Credits (attach appropriate documents)
nearest you, or our toll-free number (800) 647-7706. You may also
access our Internet home page at
TOTAL CREDIT (Transfer to page 1, line 33)
REV 40 2406 SEPT00 (07-17-00)
Page 2
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