Form 43-1 - Wyoming Sales Tax Return For Occasional Vendors

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Wyoming Dept of Revenue
Wyoming Sales Tax
Form 43-1
122 W 25th St, 2W
Return for Occasional Vendors
Cheyenne, WY 82002-0110
Please use black ink to complete form
Ownership RID:
License Number:
Report Period:
through
Return Due Date:
Part I - Summary - Do not use dollar signs, commas or periods
(Dollars)
(Cents)
Line A. Gross Sales & Services
Line B. Total Deductions (Sales & services which are exempt or not taxed)
Line C. Net Taxable Sales & Services (Line A minus Line B)
Line D. Jurisdictional Taxes Due (Part II, Line L)
Line E.
NOT USED
Line F.
NOT USED
Line G. Penalties, Interest or Dept. of Revenue Billing (See instructions)
Line H. Credit Memo from Dept. of Revenue (See instructions)
Line I.
Total Amount Due (Add Lines D & G, then subtract Line H)
Part II - Jurisdictional Tax Information
(Column 1)
(Column 2)
(Column 3)
(Column 4)
(Column 5)
(Column 6)
(Column 7)
Jurisdiction
Jurisdiction
Tax Rate
Sales Tax Due
Excess
Net Tax Due
NOT USED
Name Code
Digit Code
% in Effect
Tax Due
(Add Columns 4 & 6)
(Use CAPS)
%
%
%
%
Line J. Total Net Tax (Add totals in Column 7)
Total Number
Line K. Sum of Line 1 results from all Part III Supplemental Pages
Supplemental
Pages Included
Line L. Total Jurisdictional Tax Due (Add Lines J & K. Enter results here &
on Part I, Line D
Changed Information:
Please check appropriate box for:
Location Address Change?
Mailing Address Change?
Ownership Change?
Authorized Contact Change?
Date:
Signature:
Title:
I declare, under penalty of perjury, that I have examined this return and to the
Phone Number:
best of my knowledge and belief it is correct and complete.
Name (Printed):

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