Forest Excise Tax Return - Private Land - Small Harvester
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4State of Washington
Department of Revenue
Forest Tax Program
PO Box 47472, Olympia WA 98504-7472
1-800-548-8829, Fax (360) 534-1320
On-line at
FOREST EXCISE TAX RETURN
Quarter
Year
Private Land - Small Harvester
Make any address changes above.
ALL HARVESTING IS COMPLETED. Check this box.
If permit ownership has changed, attach transfer information.
You will no longer receive a return.
NO HARVEST THIS QUARTER. Check this box, sign your name at bottom and
mail in page 1. Or call 1-800-547-9815 from WA, OR, or ID.
SUMMARY TOTAL FROM DETAIL PAGE(S)
Check
Check if
Check to
to
Stump-
No
County
Amount
Detail
Approved
Total Taxable
Delete
Delete
Harvest
Land
Rge
age
Haul
Name/
EARR
of EARR
Page
Permit Number
Sec.
Twn
Permit
on this
Sec.*
Type
E or W
Value
Zone
Stumpage Value
Credit
#
Number
*
Sec.
Credit
Area
( )
( )
( )
* See Instructions for Closure
DUE DATE:
Grand Total Taxable
CHECK ONE:
$
AFTER DUE DATE
Stumpage Value
A
INDUSTRIAL LANDOWNER (wood using plant)
ADD PENALTY
Tax Due = Grand Total
$
B
LARGE LANDOWNER (over 1,000 acres)
See rates and
Stumpage Value Times
x
instructions on page 4
C
SMALL LANDOWNER (under 1,000 acres)
Current Rate 0.05
(Do Not Round)
$
Less EARR Credit
-
Signature
$
Subtotal
Print Name
$
Penalty
+
(Do Not Round)
Daytime Phone
Date
Total Amount Due
$
Make Check Payable To: Department of Revenue
Email Address
If subtotal for the quarter is less than $50, send completed return
without a payment.
See Reporting Instructions on Page 4
Page 1
REV 62 0064
(1/20/11)
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