Complete this form, click the print button below, sign, date, and mail to City of Littleton Sales Tax Division. 
•YELLOW FIELDS ARE REQUIRED • NUMBER FIELDS DO NOT AUTOMATICALLY CALCULATE                                                                                                            CITY OF LITTLETON

                                           TAXPAYER'S NAME AND ADDRESS                                                                                                                SALES/USE TAX RETURN
        PERIOD                                               ACCOUNT 
     COVERED   ANNUAL                                        NUMBER                                                                                                         2255 W. BERRY AVENUE - LITTLETON, CO 80120

         DUE 
         DATE                                                                                                                                                                                              303-795-3768

COMPANY NAME
                                                                                                                                                                                                              COMPUTATION OF TAX

                                                                                                                                          5.  AMOUNT OF CITY SALES TAX 3.75% OF LINE 4
     ADDRESS

                                                                                                                                          6.  ADD: EXCESS TAX COLLECTED
         CITY
                                                       STATE                                                     ZIP CODE
                                                                                                                                          7.  ADJUSTED CITY TAX:  (ADD LINES 5 & 6)

                                                                                                                                          8.  DEDUCT 2.5% OF LINE 7, MAXIMUM $100 
                                                                                                                                              (VENDORS FEE. IF PAID BY DUE DATE)
1.   GROSS SALES                     (TOTAL RECEIPTS FROM CITY ACTIVITY MUST BE REPORTED AND ACCOUNTED FOR IN EVERY                       9.  TOTAL SALES TAX 
                                     RETURN INCL. ALL SALES, RENTALS AND                                                                      (LINE 7 MINUS LINE 8)
     AND SERVICE :
                                                                                                                                          10A. CITY USE TAX                 AMOUNT SUBJECT TO TAX:
     ADD: BAD DEBTS COLLECTED                                                                                                                                                                                                                         X 3.75%=
2A.                                                                                                                                           (FROM SCHEDULE B)
                                                                                                                                          10B. LODGER’S TAX                 AMOUNT SUBJECT TO TAX: 
     TOTAL LINES 1 & 2A                                                                                                                                                                                                                               X 5%=
2B.                                                                                                                                           (ENTER AMOUNT FROM LINE 4)
3.      A.     NON- TAXABLE  SERVICE SALES                                                                                                11. TOTAL TAX DUE: (ADD LINES 9, 10A & 10B)
               (INCLUDED IN ITEM 1 ABOVE)
        B.                                                                                                                                12.                LATE FILING
               SALES TO OTHER LICENSED DEALERS FOR PURPOSES OF TAXABLE RESALE                                                                        IF RETURN IS FILED   ADD:                        PENALTY:             10%
        C.     SALES SHIPPED OUT Of  CITY AND, OR STATE                                                                                              AFTER DUE DATE THEN                              INTEREST
D              (INCLUDED IN ITEM 1 ABOVE)                                                                                                                                                             PER MONTH:        1%
E       D.     BAD DEBTS CHARGED OFF                                                                                                      13. TOTAL TAX. PENALTY AND INTEREST DUE: 
                                                                                                                                              (ADD LINES 11 AND 12)
D               (ON WHICH CITY SALES TAX HAS BEEN PAID)
                                                                                                                                          14.
U       E.     TRADE-INS FOR TAXABLE RESALE                                                                                                         ADJUSTMENTS PRIOR PERIODS                         A-ADD
                                                                                                                                                     ATTACH COPY OF OVER OR 
C       F.     SALES OF GASOLINE ANO CIGARE TET S                                                                                                                                                     B-DEDUCT:
                                                                                                                                                     UNDERPAYMENT NOTICE
T
        G.     SALES TO GOVERNMENT AND, RELIGI OUS AND CHARITABLE                                                                         15.
   I           ORGANIZATIONS                                                                                                                                                                                   MAKE CHECK OR MONEY ORD ER       
                                                                                                                                              TOTAL DUE AND PAYABLE:                                                          PAYABLE TO:
O       H.     RETURNED GOODS
                                                                                                                                                                                                                              CITY OF LITTLETON
N
        I.     PRESCRIPTION DRUGS / PROSTHETIC DEVICE                                                                                         SCHEDULE A:                                             SPECIAL MESSAGE TO AND FROM CITY/TAXPAYER
S
        J.     TOTAL GROCERY SALES

        K.     OTHER DEDUCTIONS (LIST)

     3. TOTAL DEDUCTIONS
     (TOTAL OF LINES 3a-k)
4.   TOTAL CITY NET TAXABLE SALES & SERVICE
     (LINE 2B MINUS TOTAL LINE 3)

                                               SCHEDULE - B - CITY USE TAX                                                                                                            SCHEDULE - C - CONSOLIDATED ACCOUNTS REPORT
     The Littleton Municipal Code imposes a tax upon the privilege of using, storing, distributing or otherwise
                                                                                                                                          This schedule is required in all cases in which the taxpayer makes a consolidated return which includes sales made at more than one location. It must be completely 
     consuming in the City tangible property or taxable services purchased, rented or leased.                                             filled out and convey all information required in accordance with the column headings.  If additional space is needed attach schedule in same format.
                                                                                                                                                                                                                                                              PERIODS NET TAXABLE
                                                                                                                                                                                                                                      PERIODS TOTAL GROSS
DATE OF                      NAME OF VENDOR                                TYPE OF COMM ODITY                              PURCHASE       ACCOUNT                                     BUSINESS ADD RESSES                                                     SALES (AGGREGATE TO 
                                                                                                                                                                                                                                   SALES (AGGREGATE TO LINE
PURCHASE                         ADDRESS                                                      PURCHASED                    PRICE          NUMBER                                OF CONSOLIDATED ACCOUNTS                                 1 TOP OF RETURN)                                      LINE
                                                                                                                                                                                                                                                                4 TOP OF RETURN)

                  (A) LIST OF PURCHASES (IF ADDITIONAL SPACE NEEDED - ATTACH SCHEDULE IN SAME FORMAT)                                                                                                                         $                               $

     (B) TOTAL PURCHASE PRICE OF PROPERTY SUBJECT TO CITY USE TAX
     ENTER TOTAL LINE (B) ON LINE 10 ON TOP OF RETURN                                                                                     ENTER TOTALS HERE AND TOP OF RETURN
                                                                                                                         $                                                                                                    $                               $

                                               NEW BUSINESS DATE           1. If ownership has changed, give date of change and the new owner's name.
                                                   M/D/YYYY                2. II business has been permanently discontinued, give date discontinued.
                                                                           3. If business location has changed, give new address                                                                                              PRINT THIS DOCUMENTPRINT

                                                                           4. Records are kept at what address?
                                               DISCONTINUE DATE            5. If business is temporarily closed, give dates to be closed.                                                                                  CLICK THE ABOVE BUTTON TO PRINT
                                                   M/D/YYYY                6. If business is seasonal, give months of operation.                                                                                           THIS DOCUMENT, THEN SIGN AND

                                                                           7. If this return includes sales for more than one location, refer to and complete schedule 'C'.                                                MAIL TO:

                                     SHOW BELOW CHANGE OF OWNERSHIP AND/OR                                               I, hereby certify, under penalty of perjury, that the statements made herein                      CITY OF LITTLETON
                                     ADDRESS, ETC.                                                                       are to the best of my knowledge true and correct.
                                                                                                                                                                                                                           PO BOX 1305

                                                                                                                           BY:  _____________________________________________________                                      ENGLEWOOD, CO 80150-1305

                                                                                                                           COMPANY:

                                                                                                                           PHONE:

                                               BUS. ADDRESS                                   MAIILNG ADDRESS                       TITLE                                   DATE