FORM   850       IDAHO SALES AND USE TAX RETURN                                                                                                         RT0850
                                                                                Mailing Address Change                                    Cancel Permit 4/18/2003
PERMIT NO.                                      FROM      TO
002566412            09/01/2022                           09/30/2022
                     TAX DUE ON OR BEFORE                                      1.  Total Sales ........................................  •
                     10/20/2022                                                2.  Less nontaxable sales ...........................     •
                                                                               3.  Net taxable sales (line 1 minus line 2)......
                                                                               4.  Items subject to use tax.........................     •
REVENUE OPERATIONS QUALITY CONTROL                                             5.  Total taxable (add lines 3 and 4).............
PO BOX 36                                                                      6.  Tax (6% of Line 5)...............................     •
BOISE ID  83722-0036                                                           7.  Adjustments (attach explanation).............         •
                                                                               8.  Tax due (total of lines 6 and 7)...............
                                                                               9.  Penalty (add after due date) ....................     •
I do hereby swear or affirm that this information         Mail to:             10.  Interest (add after due date).....................   •
is true and correct to the best of my knowledge           State Tax Commission 11.  Total due............................................
Authorized Signature                                 Date PO Box 76
                                                          Boise, Idaho 83707

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