Combined Excise Tax Return Form - Washington State Department Of Revenue

LODGING TAXES

TRANSIENT RENTAL INCOME INFORMATION

TOURISM PROMOTION AREA LODGING CHARGE

Code 47

Code 170

Line

Number of

Unit/Day Rate

Location Code

Income

Location Code

Total Charges Due

Unit/Days

Charged

No.

(

enter location code and income only)

TOTAL TOURISM PROMOTION AREA LODGING CHARGE

CONVENTION AND TRADE CENTER TAX

Code 48

SPECIAL HOTEL/MOTEL TAX

Code 70

Line

Location Code

Taxable Amount

Rate

Tax Due

Location Code

Taxable Amount

Rate

Tax Due

No.

TOTAL CONVENTION & TRADE CENTER TAX

TOTAL SPECIAL HOTEL/MOTEL TAX

OTHER TAXES

Line

Column I

Col. 2 Deductions*

Column 3

Col. 4

Column 5

Tax Classification

Code

No.

Gross Amount

Totals from Pg. 4

Taxable Amount

Rate

Tax Due

Tobacco Products/Cigars (less than $0.69)

.95

Refuse Collection

.036

Temporarily Not Due – Fund Limit Reached

Petroleum Products Tax

.003

Hazardous Substance

.007

Intermediate Care Facilities

.06

Line

Tax Classification

Code

Item

Quantity

Rate

Tax Due

No.

Number of Stoves, Fireplaces, & Solid

Solid Fuel Burning Device Fee

30.00

Fuel Burning Devices Sold:

Syrup Tax

Number of Gallons (whole numbers only) Sold:

1.00

Tire Fee

Number of Tires Sold:

.90

Cigar Tax ($0.69 or more)

194

Number of Cigars ($0.69 or more):

.65

198

Little Cigar Tax (acetate integrated filters)

Number of Little Cigars:

.15125

162

Number of Units:

Moist Snuff (1.2 oz. or less)

2.526

163

Number of Ounces (including partial ounces):

Moist Snuff (more than 1.2 oz.)

2.105

* Deductions taken but not itemized on page 4 will be disallowed.

TOTAL OTHER TAXES

(add lines 49-60)

Additional Information

The easiest way to file your return is to use our free E-file

CREDITS

service at dor.wa.gov

Line

Credit

Credit Classification

Amount

Penalties and Interest

No.

I.D.

Penalties:

61 Multiple Activities Tax Credit (attach Schedule C)

800

 Any unpaid tax (including partial payments) is subject to delinquent

return penalty at the rate on the front of the return. (RCW 82.32.090)

62 International Services Credit

855

 A 5% assessment penalty may be assessed if the return is

substantially underpaid. (RCW 82.32.090)

63 Small Business B&O Tax Credit (go to dor.wa.gov)

815

Interest: Interest will accrue from the first day of the month following

the due date, until paid. (RCW 82.32.050)

64 Renewable Energy System Cost Recovery Credit

925

Internet Assistance – Go to DOR’s home page at dor.wa.gov

 Get tax return information and instructions, penalty waiver

65 Bad Debt Tax Credit (attach Schedule B)

801

information, and more.

 Get the Local Sales and Use Tax Addendum, and other tax-related forms.

66 Hazardous Substance

805

 Update your account information or close your account with the

Public Utility Tax Credit for Billing Discounts/Qualified

Department of Revenue.

880

Contributions to a Low Income Home Energy Assistance Fund

Telephone Assistance

 If you did not have business activity call 1-800-647-7706. At the greeting,

68 Tobacco Products Tax Credit

930

enter 1 at each prompt, your 9 digit tax registration number, and then

follow the instructions given. Do not mail a paper return back to the

69 B&O Credit for Syrup Tax Paid

945

Department.

 For penalty waiver criteria information, call 1-800-334-8969 and

70 Destination Sourcing Tax Credit

602

enter code 429.

 For business closure information, call 1-800-334-8969 and enter

71 Other Credits (attach appropriate documents)

810

code 430.

For tax assistance or to request this document in an alternate format,

TOTAL CREDIT (transfer to page 1, line 32)

please call 1-800-647-7706. Teletype (TTY) users may use the

Washington Relay Service by calling 711.

Internet/Fax

(01/14/15)

Page 2

Combined Excise Tax Return Form - Washington State Department Of Revenue - 2015 Page 2

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