Form 0405-200 - Tire Fees Quarterly Return Page 2

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Alaska
200
Tire Fees Quarterly Return
Schedule A - Tire Inventory
AK Business License #
EIN
SSN
Name
Calendar Quarter Ending
Attach this schedule to your Tire Fees Quarterly Return.
Column A (new unstudded tires subject to the tire fee) This includes all new tires manufactured for vehicles designed for highway use.
This does not include new studded tires (see Column B) or off-road tires, used tires, or tires upon which the fee has already been paid.
Column B (new studded tires subject to the tire fee) This includes all new studded tires manufactured for vehicles designed for highway
use. This does not include used studded tires or studded tires upon which the fee has already been paid.
Column C (total new tires subject to the tire fee) This should equal column A plus column B.
New unstudded tires
New studded tires
Total new tires subject to
subject to the tire fee
subject to the tire fee
the tire fee
(A)
(B)
(C)
Inventory on the first day of the quarter (this
1.
should equal the inventory from the last day of
0
the previous quarter)
Add: Tires purchased, produced, or otherwise
2.
0
received during the quarter
Less: Tires sold or transferred during the quarter
3.
0
(this includes sales to exempt purchasers)
4. Adjustments (attach an explanation)
0
5. Inventory on the last day of the quarter
0
Explanation
200
0405-200 Rev 10/12 - page 2

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