City Of North Bend Business And Occupation Tax Report Form

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CITY OF NORTH BEND BUSINSS and OCCUPATION TAX REPORT
RETURN ORIGINAL
Questions?
(425) 888-1211
Under City of North Bend Municipal Code Chapter 5.04, 5.05 & 5.06
ALL BUSINESSES MUST FILE A BUSINESS AND OCCUPATION TAX REPORT
ACCOUNT NUMBER
You must pay Business and Occupation Tax when the total of your quarterly taxable gross receipts exceed the following levels for
your business classification(s):
Classification
Quarterly Taxable Gross Receipts
Utilities
$150.00
PERIOD
DATE DUE
All other Classifications
$5,000.00
NAME
ADDRESS
CITY, STATE
ZIP CODE
LOCATION
BE SURE THAT NAME, ADDRESS, AND ZIP CODE ARE CORRECT
1st QTR = (JAN, FEB, MAR)
2nd QTR = (APR, MAY, JUN)
Need a form or code reference? See:
3rd QTR = (JUL, AUG, SEP)
4th QTR = (OCT, NOV, DEC)
COLUMN 3
COLUMN 4
COLUMN 1
COLUMN 2
COLUMN 5
COLUMN 6
DEDUCTIONS
TAXABLE AMOUNT
BUSINESS CLASSIFICATION
GROSS RECEIPTS AMOUNT
X RATE
= TAX DUE
OFFICE USE
(SHOW DETAIL BELOW)
(COLUMN 2 – [MINUS] COLUMN 3)
ONLY
UTILITIES
1
RECEIPT
NUMBER
MANUFACTURING
2
WHOLESALE
3
RETAIL
4
CONSTRUCTION
5
REPAIR
FINANCIAL
6
INSTITUTIONS
PROFESSIONAL
7
SERVICES
SCHOOL/DAY CARE
8
NURSING
OTHER
9
PENALTY:
LINE A - Total of Column 6
1 to 30 days late ....... add 5% of tax due (minimum penalty $5.00)
31 to 60 days late ...... add 15% of tax due (minimum penalty $5.00)
LINE B - Penalty
61 or more days late .. add 25% of tax due (minimum penalty $5.00)
LINE C -
Overpayment/Underpayment
MAIL TAX RETURNS TO:
City of North Bend
(-) = Credit Balance (subtract)
PO Box 896
Positive amount = Balance due (add)
North Bend, Washington 98045
LINE D - Total Tax and Penalty
(Attach Payment)
PLEASE MAKE CHECK PAYABLE TO: City of North Bend
Type of Deduction
Explanation
Amount
Examples of the most common exemptions and deductions:
• Liquor, beer and wine sales
• Manufacturing, selling or distribution motor vehicle fuel
• Cash discounts taken by customers
• Credit losses or bad debts sustained by sellers
• Agricultural products produced and sold by the same farmer and /or gardener
• Gross receipts reported to and taxed by another city
STATEMENT BY TAX PAYER
I/we hereby certify under the penalties of perjury that the sum above shown is the amount of tax for which I am/we are liable for the period above
shown under and computed according to the provisions of this Ordinance. I/we further certify that the information herein given and the amount of
the tax liability herein reported are full and true and I/we know the same to be so.
SIGNED
DATE
(Firm Name)
BY
TITLE
(Authorized Agent)

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