Privilege Sales And Use Tax Return - City Of Glendale
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4PRIVILEGE (SALES) TAX RETURN
Mailing Address Change?
City of Glendale
(Complete the box below)
5850 W. Glendale Ave.
FOR CITY USE ONLY
Glendale, AZ 85301
ACCOUNT INFORMATION
License #
-
Period Ending
-
(MM YY)
Business Name __________________________
Filing Frequency
In Care of _______________________________ Phone __________________
THIS RETURN IS DUE ON THE
TH
20
OF THE FOLLOWING MONTH
Mailing Address __________________________________________________
To cancel your license
,
Mailing City, State Zip _____________________________________________
check the box at the left, note reason and date
of cancellation and sign the bottom of the form.
Reason
Effective
Date
MM
DD
YY
If you had no business activity
in this period, check here and sign at the bottom
This is an Amended Return
THIS FORM MUST BE RETURNED TO THE CITY EVEN IF THERE IS NO TAX DUE
Deductions must be detailed on the
Column 1
Column 2
Column 3
Column 5
Col. 4
back of the form
Bus.
Gross Receipts
Less: Deductions
Column 1 – Column 2
X Tax
Business Activity
= Tax Amount
Class
or Jet Fuel Gallons
From Sch A on back
= Net Taxable
Rate
0.00
1
99
0.00
Use Taxable Purchases
XXXXXXXXXXXXXX
XXXXXXXXXXXXXX
2.2%
0.00
0.00
0.00
0.00
2
0.0%
0.00
0.00
0.00
0.00
0.0%
3
0.00
0.00
0.00
0.00
4
0.0%
XXXXXXXXXXXXXX
5
TOTAL FROM ADDITIONAL TAX RETURN PAGE(S)
Plus (+)
6
ENTER EXCESS CITY TAX COLLECTED (From SCHEDULE C on the back)
Plus (+)
0.00
0.00
7
GRAND TOTAL (Add Lines 1 through 6)
Equals (=)
PENALTY AND INTEREST (5% late filing per month and 10% late payment. Variable
8
Plus (+)
interest rate charged monthly as described in City Code Section 21.1-540(a).)
0.00
9
Equals (=)
ENTER TOTAL LIABILITY (Line 7 plus Line 8)
10
Minus (-)
0.00
ENTER CREDIT BALANCE TO BE APPLIED (From SCHEDULE B on back)
11
Equals (=)
0.00
ENTER NET AMOUNT DUE (Line 9 minus Line 10)
12
ENTER TOTAL AMOUNT PAID (Payable to City of Glendale). Write your account number on your check.
FOR CITY USE ONLY
Phone Number
Signature of Taxpayer/Paid Preparer
Date
Phone Number
Printed Name of Taxpayer/Paid Preparer
Phone Number
Click here to PRINT RETURN
Under penalties of perjury, I declare I have examined this return, including the accompanying schedules
and statements, and to the best of my knowledge and belief it is true, correct and complete. The
declaration of the paid preparer is based upon all information of which the preparer has any knowledge.
A SIGNATURE IS REQUIRED TO VALIDATE THIS RETURN.
SEND THIS ORIGINAL ONLY
KEEP A COPY FOR YOUR RECORDS
Print version 04/2010-1
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