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                           CITY OF APACHE JUNCTION PRIVILEGE (SALES) TAX RETURN

                                City of Apache Junction 
                                Tax & Licensing Division                                             License                             Due Date 
                                300 E. Superstition Blvd. 
                              Apache Junction, AZ  85119 
                                Phone:  (480) 474-5051                                        Period Begins                             Period Ends 
                                    Fax: (480) 982-8004

                                                                                                    Cancel License Date: 

 Business Name                                                                                Reason:
 Street or PO Box
                                                                                                    No income this period.  Sign and 
 Suite or Apartment                                                                                 date below.
 City                                   State Zip
                                                                                                    Address change:  Enter new 
                                                                                                    address to the left.
 State Tax License

                                              Column 1           Column 2            Column 3        Column 4                           Column 5
                                                                 Less (-) Deductions Equals (=) Net  (X) Tax                            Equals (=) Tax 
 Business Description      Line Business Gross Income            From Schedule A     Taxable Income  Rate                                Amount
                                Class
                           1    000                          0.00

                           2    000                          0.00

                           3    000                          0.00

                           4    000                          0.00

                           5        000                      0.00

                           6    SUBTOTAL (Add lines 1 thru 5 in Column 5)                            Equals (=)
                           7    TOTAL FROM ADDITIONAL PAGES (if any)                                 Plus (+)                                  0.00

                           8    SUBTOTAL (Add Lines 6 and 7)                                         Equals (=)
                           9    EXCESS CITY TAX COLLECTED (From Schedule B on Page 2)                Plus (+)
                           10   GRAND TOTAL (Add Lines 8 and 9)                                      Equals (=)
                           11   PENALTIES AND INTEREST (See instructions)                            Plus (+)                                  0.00

                           12   TOTAL LIABILITY (Add Lines 10 and 11)                                Equals (=)
                           13   ENTER CREDIT BALANCE (From Schedule C on Page 2)                     Minus (-)                                 0.00

                           14   NET AMOUNT DUE (Subtract Line 13 from Line 12)                       Equals (=)
                           15   ENTER AMOUNT PAID (Payable to the City of Apache Junction)                                                     0.00
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge  
and belief it is true, correct, and complete.  Declaration of preparer (other than the taxpayer) is based on all information available. 
 
                                                                                                     DO NOT WRITE IN THIS AREA
                           TAXPAYER                              PREPARER

 Print Name:                                  Print Name:

 Signature:                                   Signature:

 Date:                                        Date:
                                A SIGNATURE IS REQUIRED TO MAKE THIS A VALID RETURN
                           THIS FORM MUST BE RETURNED TO THE CITY EVEN IF THERE IS NO TAX DUE

AJ Form 100 (February 2008)

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License: Report Period: to Page 2
Due Date: The due date for the City privilege tax is the 20th of the month following the reporting period. A return is considered timely only when
received by the last business day of the month. A business day is any day except weekend days and legal City holidays.
POSTMARKS ARE NOT ACCEPTED AS EVIDENCE OF TIMELY FILING
Penalties: 1. Failure to File: 5% of the tax due for each month or fraction of a month between the delinquency date and the date on which the return
is filed.
2. Late Payment: 10% of the unpaid tax if the tax was not paid by the delinquency date.
3. Total Penalty: Total penalties will not exceed 25% of the total tax due.
Interest: Daily interest will be assessed on delinquent taxes at the rate established by the Internal Revenue Service (IRS).
You are not required to calculate penalties and interest. The City will calculate penalties and interest, and will notify you of the amount
which you may pay on your next tax return, or pay separately.
1. Check the amounts recorded for each business class on Page 1.
2. Itemized deductions on Schedule A should equal total deductions recorded on Page 1.
CHECK YOUR RETURN: 3. Taxable income must equal gross income less total deductions.
4. Tax due must equal the taxable income multiplied by the specified tax rate.
5. Total tax due must include any excess tax collected.
SCHEDULE A - DETAIL OF DEDUCTIONS
Enter below the deductions and exclusions you used in computing your City privilege tax.
You must keep a detailed record of all deductions and exclusions. Failure to maintain proper documentation and records may result in disallowance.
Line 1 Line 2 Line 3 Line 4 Line 5
Code
Total tax collected or factored
(State, county, and city) 01 0.00 0.00 0.00 0.00 0.00

Qualified Out-of-City sales. 02 0.00 0.00 0.00 0.00 0.00

Qualified Out-of-State sales. 03 0.00 0.00 0.00 0.00 0.00
Sales to a qualifying hospital, community health care
center, or health care organization. 05 0.00 0.00 0.00 0.00 0.00

Sales for resale (retail, rental equipment, and utilities). 10 0.00 0.00 0.00 0.00 0.00

Separately billed delivery, installation, repair, and/or 0.00 0.00 0.00 0.00 0.00
maintenance charges. 11
Sales of natural gas or petroleum used to propel a 0.00 0.00 0.00 0.00 0.00
motor vehicle. 13
Sales of prescription drugs or prosthetics. 16 0.00 0.00 0.00 0.00 0.00
Sales of property which directly enters into a finished
manufactured product. 19 0.00 0.00 0.00 0.00 0.00

Sales of food purchased with food stamps or a food 0.00 0.00 0.00 0.00 0.00
stamp instrument. 64
Bad debt on which tax has been paid. 85 0.00 0.00 0.00 0.00 0.00

Discounts, refunds, or returns. 86 0.00 0.00 0.00 0.00 0.00

Trade-ins (retail only). 87 0.00 0.00 0.00 0.00 0.00

Construction contracting standard 35% deduction. 04 0.00 0.00 0.00 0.00 0.00

Exempt sub-contracting income. 33 0.00 0.00 0.00 0.00 0.00
Other
Specify: 0.00 0.00 0.00 0.00 0.00
Other
Specify: 0.00 0.00 0.00 0.00 0.00
Other
Specify: 0.00 0.00 0.00 0.00 0.00
Other
Specify: 0.00 0.00 0.00 0.00 0.00

TOTAL DEDUCTIONS:
SCHEDULE B - Excess tax collected by 0.00 0.00 0.00 0.00 0.00
activity
TOTAL EXCESS TAX: 0.00
SCHEDULE C - Allowed credits (attach 0.00 0.00 0.00 0.00 0.00
separate schedule)
TOTAL CREDITS CLAIMED: 0.00

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