TAXPAYER'S NAME AND ADDRESS
PERIOD ACCOUNT
COVERED NUMBER
DUE SALES/USE TAX RETURN
DATE
Mail Completed Return with Payment to:
LEGAL NAME Enter Taxpayer Legal Name P.O. Box 17107
MAILING C/O Enter Mailing Care of Denver, CO 80217-7107
MAILING ADDRESS Enter Mailing Address
(303) 658-2065 https://www.cityofwestminster.us
CITY, STATE, ZIP CODE Enter City, State, Zip Code
COMPUTATION OF TAX
1. GROSS SALES ACCOUNTEDTOTALFORRECEIPTSSERVICESIN EVERYFROMRETURNBOTHCITYTAXABLEINCL.ACTIVITYSALESANDMUSTNON-TAXABLERENTALSBE REPORTEDAND LEASESANDAND ALL 5. AMOUNT OF CITY SALES TAX 3.85% OF LINE 4
AND SERVICE
2A. ADD: BAD DEBTS COLLECTED 6. ADD: EXCESS TAX COLLECTED
2B. TOTAL LINES 1 & 2A 7. TOTAL CITY SALES TAX (ADD LINES 5 & 6)
3. A. NON-TAXABLE SERVICE SALES 8. CITY USE TAX (FROM SCHEDULE B)
(INCLUDED IN ITEM 1 ABOVE) AMOUNT SUBJECT TO TAX x 3.85% =
B. SALES TO OTHER LICENSED DEALERS 9. TOTAL TAX DUE (ADD LINES 7 & 8)
FOR PURPOSES OF TAXABLE RESALE
C. SALES SHIPPED OUT OF CITY AND/OR STATE LATE FILING PENALTY
(INCLUDED IN ITEM 1 ABOVE) 10. IF RETURN IS FILED 10% OF TAX ($15 MIN)* ▼ TOTAL PENALTY & INTEREST ▼
BAD DEBTS CHARGED OFF AFTER DUE DATE
D D. (ON WHICH CITY SALES TAX HAS BEEN PAID) ADD: INTEREST
1% PER MONTH
E E. TRADE-INS FOR TAXABLE RESALE MAKE CHECK OR MONEY
D 11. TOTAL DUE AND PAYABLE ORDER PAYABLE TO
U F. SALES OF GASOLINE AND CIGARETTES CITY OF WESTMINSTER
C SALES TO GOVERNMENT AND
T G. CHARITABLE ORGANIZATIONS SPECIAL MESSAGE TO TAXPAYER:
I H. RETURNED GOODS Did you know you could file online? Please visit our website and learn more
O PRESCRIPTION DRUGS AND
N I. PROSTHETIC DEVICES about F.A.S.T File or call the Sales Tax Division at 303-658-2065
S J. https://www.cityofwestminster.us/OnlineTaxFiling
K. SCHEDULE A SPECIAL MESSAGE TO CITY FROM TAXPAYER
L. _______ CHECK HERE FOR BUSINESS CLOSURE/CHANGE OF OWNERSHIP
3. TOTAL DEDUCTIONS (TOTAL OF LINES 3 A THROUGH L) _______ CHECK HERE FOR CHANGE OF ADDRESS
4. TOTAL CITY NET TAXABLE SALES & SERVICE (LINE 2B LESS LINE 3) COMPLETE THE BOTTOM PORTION IF ANY OF THE ABOVE APPLY. ALWAYS SIGN BOTTOM OF FORM
SCHEDULE B - CITY USE TAX
THE WESTMINSTER MUNICIPAL CODE IMPOSES A TAX UPON THE PRIVILEGE OF USING, STORING, DISTRIBUTING, OR OTHERWISE
CONSUMING IN THE CITY TANGIBLE PERSONAL PROPERTY OR TAXABLE SERVICES PURCHASED RENTED OR LEASED.
PURCHASE VENDOR NAME TYPE OF COMMODITY PURCHASE
DATE ADDRESS PURCHASED PRICE
ENCLOSE ADDITIONAL SHEETS IN SAME FORMAT IF NEEDED TOTAL PURCHASE PRICE OF PROPERTY & SERVICES SUBJECT
TO CITY USE TAX (ENTER ON LINE 8 ABOVE)
CLOSURE/OWNERSHIP CHANGE DATES SUBMIT OWNERSHIP/ADDRESS CHANGE TO CITY CLERK: TAXPAYER SIGNATURE (REQUIRED)
I HEREBY CERTIFY, UNDER PENALTY OF PERJURY, THAT THE STATEMENTS
MADE HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
NEW BUSINESS MO DAY YR City of Westminster Phone:
START DATE City Clerk 303-658-2162 BY:
4800 W. 92nd Ave. Fax:
DISCONTINUED MO DAY YR Westminster, CO 80031 303-706-3924 TITLE:
BUSINESS DATE
E-mail Address: licensing@cityofwestminster.us PHONE: DATE:
IMPORTANT REMINDERS:
1. INCLUDE WESTMINSTER ACCOUNT NUMBER, NAME, AND ADDRESS IN THE UPPER LEFT.
2. INCLUDE THE PERIOD FOR WHICH YOU ARE FILING.
3. THE DUE DATE IS THE 20TH OF THE MONTH FOLLOWING THE END OF THE REPORTING PERIOD.
4. YOUR WESTMINSTER ACCOUNT NUMBER IS NOT YOUR FEIN # OR YOUR STATE OF COLORADO
DEPARTMENT OF REVENUE ACCOUNT NUMBER.
5. IF YOU HAVE RECENTLY APPLIED FOR A WESTMINSTER ACCOUNT NUMBER, WRITE "APPLIED FOR"
AND THE APPLICATION DATE IN THE ACCOUNT NUMBER AREA.
6. ZERO LIABILITY RETURNS MAY BE FAXED TO (303) 706-3923 (PRIOR TO THE DUE DATE) OR
FILED ELECTRONICALLY AT WWW.CITYOFWESTMINSTER.US. IF YOU FILE ELECTRONICALLY OR FAX
A RETURN, DO NOT MAIL A COPY.
7. A RETURN IS REQUIRED EVEN IF NO TAX IS DUE. LATE RETURNS ARE SUBJECT TO PENALTY.