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                                                                                                                                          SELLERS USE TAXSELLERS USE TAXSALES & USE TAX
                                                                                                                                          MONTHLY TAX RETURNMONTHLY TAX RETURNMONTHLY TAX RETURN

                                                                                                                                                                                                                                                                  MONTHM  COVERED BY THIS REPORTMONTH COVERED BY THIS REPORTONTH COVERED BY THIS REPORT
                                                                                                                                                                                                                                                    ORO R OR 
                                                                                                                                                                                                                                                                  PERIODP COVEREDPERIOD COVEREDBY THIS REPORTERIODBY THIS REPORTCOVERED BY THIS REPORT
                                                                                                            www.cityofmobile.org/revenuewww.cityofmobile.org/revenuewww.cityofmobile.org/html/departments/revenuewww.cityofmobile.org/revenue131312     From:                                            FFrom:                                            To:rom:                                            To:                                                      To:
CITY OF MOBILE  •  DEPARTMENT 1519  •  P.O. BOX 11407  •  BIRMINGHAM, AL 35246-1519  •  251-208-7462CITY OF MOBILE • P.O. BOX 2745 • MOBILE, AL 36652-2745 • PHONE (251) 208-7461CITY  OF  MOBILE  •  DEPT#  1519  •  P.O.BOX  11407  •  BIRMINGHAM,  AL  35246-1519  •  PHONE  (251)  208-7462CITY  OF  MOBILE  •  DEPT#  1519  •  P.O.BOX  11407  •  BIRMINGHAM,  AL  35246-1519  •  PHONE  (251)  208-7462
                                                                                                      FIGURESFMAY BE ROUNDED TO NEAREST DOLLARFIGURES MAY BE ROUNDED TO NEAREST DOLLARIGURES MAY BE ROUNDED TO NEAREST DOLLAR

        IsIs this a final return  IsYes   Ythisa Yes  finalNo..No                                            return es  NoIIf yes,thisIfattachyes,a finalattachexplanationreturn explanationand dateandcloseddate closed_____/_____/_____.f_____/_____/_____attachyes,                                                                                                                                                                                                 explanation and date closed _____/_____/_____

                                                                                                                                                                                          TAXTDUE AT CITY RATE                       TAX DUE AT P/J RATETAX DUE AT CITY RATE                       TAX DUE AT P/J RATEAX DUE AT CITY RATE                       TAX DUE AT P/J RATE

1.1. Gross Receipts/Use Tax1. Gross Receipts/Use TaxGross Sales/UseCol.ColCol.AA--5%4%          Tax                                                                                                  Col.Col.BB-2%             - 2.25%                            Col.Col.CC-2%           - 2.5%                                                                                                                                  Col.Col.D-1%Col.D - 1.125%A - 4%           Col. B-2%              Col. C-2%            Col. D-1%. A - 4%           Col. B-2%              Col. C-2%            Col. D-1%
  (A) Total sales of new and used vehicles, semi-trailersi-trailers(A) Gross sales of new and used vehicles,(A) Total sales of new and used vehicles, semsemi-trailers
        andandtrucktruckandtrailerstruckdeliveredtrailers deliveredinto Mobile,intoAL.Mobile, AL.trailers.
  (B)(B)TotalGross(B)salesTotalofsalesmachinesof machinesand replacementand replacementparts useddparts usedsales of machines and replacement parts use
        ininmanufacturingmanufin manufacturingprocessprocessdelivereddeliveredinto Mobile,intoAL.Mobile, AL.acturing process.
  (C)(C)TotalGross(C)salesTotalfromsalesplacesfromofplacesamusement.t.of amusement.sales from places of amusemen
  (D) Fair market value of properly purchased at wholesaleholesale(D) Fair market value of properly purchased at wholesale(D) Fair market value of properly purchased at w
        withdrawnwithdrawwithdrawnfor use orforotherwiseuse or otherwisedisposeddisposedof.                                               of.n for use or otherwise disposed of.
  (E)(E)RetailReta(E)sellingRetailpricesellingof propertyprice of propertyused withinusedthewithinCitytheor                                                               City oril selling price of property used within the City or
        PJPJononwhichwhPJ onMobilewhichtaxMobilehas nottaxbeenhas notpaid.been paid.ich Mobile tax has not been paid.
  (F) Total sales of liquid fuel, gaseous fuel and/or any otherny other(F) Gross sales of liquid fuel,(F) Total sales of liquid fuel, gaseous fuel and/or agaseous fuel and/or any other
        fuel for usefuelbothfor useonbothand offonhighways.ighways.fueland off h                                                          for use both on and off highways.
  (G)(G)TotalGross(G)salesTotalofsalesbeer,ofliquor,beer,wineliquor,and/orwineotherand/oralcoholicother alcoholicsales of beer, liquor, wine and/or other alcoholic
        beverages.verages.beverages.be
  (H) Total(H)salesTotalof salesallbusinessofallbusinessdelivereddeliveredinto Mobile,intoALMobile, AL
  (H) Gross sales from not included above.not included above.all business not included above.
  (I)(I)CollectionsCollections(I) Collectionsmademadeduringduringmademonthmonthduringononmonthcreditcreditonsalesditsalescre              sales
        heretofore claimed as deductions on sale of receivables.heretofore claimed as deductions on sale of receivables.heretofore claimed as deductions on sale of receivables.
2.2. TOTALTOTAL2.OFOFTOTALEACHEACHOFCOLUMNCOLUMNOLUMNEACH C
  (Lines(Lines A,B,C,D,E,F,G,H & I above)A,B,C,D,E,F,G,H(Lines A,B,C,D,E,F,G,H& I above)I&            above)
  LESS: TOTAL DEDUCTIONS-LINE 4 ON REVERSE SIDELESS: TOTAL DEDUCTIONS-LINE 4 ON REVERSE SIDELESS: TOTAL DEDUCTIONS-LINE 4 ON REVERSE SIDE
5.5. TOTALTOTAL OFOF AMOUNTSAMOUNTS REMAININGREMAINING ASAS MEASUREMEASURE OF5.OF                                                                                         TOTAL OF AMOUNTS REMAINING AS MEASURE OF
  TATAXX each column, line 2 minus line 4 from Reverse Sideeach column, line 2 minus line 4 from Reverse SideTAX each column, line 2 minus line 4 from Reverse Side
6.6. AMOUNTAMOUNTOFOFTATAXX Each column (Line 5 x Applicable rateEach column (Line 5 x Applicable rate6. AMOUNT OF TAX Each column (Line 5 x Applicable rate
  shownshown at top of column).at top of column).shown at top of column).
7.7. NumberNumber7. Numberofof newnew vehiclesvehiclesof new vehicleswithdrawnithdrawnwithdrawnw
                    ____________________________________xx $5.00$5.00 (Col.B)(Col.B)x $5.00CITYl.B)CITY(Co    CITY
                    ____________ x $2.50 (Col.D) PJ____________ x $2.50 (Col.D) PJ____________ x $2.50 (Col.D) PJ
8. AMOUNT OF TAX - Each Col.8. AMOUNT OF TAX - Each Col.8. AMOUNT OF TAX - Each Col.
9. Add ______________% Penalty - (SEE BELOW*)9. Add ______________% Penalty - (SEE BELOW*)9. Add ______________% Penalty - (SEE BELOW*)

10. TOTAL EACH COL.10. TOTAL EACH COL.10. TOTAL EACH COL.                                                                                                                               $ $                          $                         $                        $                          $                         $                                                 $                         $                        $ $     $

                                                                                                      TOTALTOTAL PAYMENT ENCLOSE PAYMENT ENCLOSEDITH THIS REPORTWITH THIS REPORTTOTAL PAYMENT ENCLOSED WITH THIS REPORTD W
                                                                                                                                                                                                                                                                  $$ $

IFI  BUSINESS NAME IS IMPRINTED,THIS RETURN MAY BE USED ONLY BYTHE BUSINESS NAMED.IF BUSINESS NAME IS IMPRINTED,THIS RETURN MAY BE USED ONLY BYTHE BUSINESS NAMED.F BUSINESS NAME IS IMPRINTED,THIS RETURN MAY BE USED ONLY BYTHE BUSINESS NAMED.
                                                                                                                                                                                                       *PENALTY*PENALTY*PENALTOF  5% OF OF PER 5% 5% MONTHYPER PER MONTHMONTH
                    ACCOUNT #ACCOUNT #                                                                                                                                                                 WHENWHENWHENPAIPAIDDPAID AFAFTERTERAFTER20TH20TH 20THOFOF                                                                                                                                                                                                       OF
                    AccountNAME           Number:NAME                                                       -                                                                                          MONTH MONTH  FOLLOWING FOLLOWING  THE THE  PERIODPERIODMONTH  FOLLOWING  THE  PERIOD
                                                                                                                                                                                                       COVERED.COVERED.COVERED.
                        ADDRESS ADDRESS
                                                                                                                                                                                                                                                    This Treport, including  accompanying  schedules  orThis  report, including  accompanying  schedules  orhis  report, including  accompanying  schedules  or
                                                                                                                                                                                                                                                    statements,shas  been  examined  by  me  and  is  to  thestatements, has  been  examined  by  me  and  is  to  thetatements, has  been  examined  by  me  and  is  to  the
                                                                                                                                                                                                                                                    bbest  of  my  knowledge  and  belief, a  true  and best  of  my  knowledge  and  belief, a  true  and est  of  my  knowledge  and  belief, a  true  and 
________________________________   __________________________________________   _______________________________________________  comcomplete __________________________________________  report  made  in  good  faith  for  the _______________________________ periodcomplete  report  made __________________________________________  in  good  faith  for  the  periodplete _______________________________report  made  in  good  faith  for  the  period
Date                  D Date                  SigSignature                                                          ate                   TitleSignature                                                          sstated.Titlenature                                                          stated.tated.                                                                                                                          Title 
                                                                                                                                                                                                                                                                                                                                                                                                                                            REV. 5/11/2010REV. 9/3/2008



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                                                  ATTACH ADDITIONAL SHEETS IF NEEDED

SCHEDULE “C” - RETAIL DEALERS IN GASOLINE INFORMATION RETURN
                                                                Gallons of diesel                     Gallons of                    -Other-
                                                                purchased to be                       Kerosene                      name fuel &
                                        Gallons of gasoline     retained for       Dollar Value of  purchased to be
Name & Address of Supplier              and aircraft fuel                          diesel purchased   retained for Dollar Value of  report no. of gallons                   Dollar Value
                                                                                                                   Kerosene         to be retained for                      of other
                                        purchased               High-       High-                   High-  High-   purchased        High- Non                               purchased
                                                                way            way                  way    way                      way   Highway
                                                                Use            Use                  Use    Use                      Use    Use

                  - SCHEDULE OF WHOLESALE SALES. WHOLESALE SALES ARE SALES FOR RESALE - ATTACH COPIES OF
SCHEDULE “D”        INVOICES WHEN CLAIMING DEDUCTION.
Customer’s Retail
Sales Account                  Customer’s Name                                                     Address                              Total Amount Sold
   Number                                                                                                                               To Each Customer

                                                                                                                                   $
                  - SCHEDULE OF SALES TO CITY OF MOBILE DIRECT PAY PERMIT HOLDERS - ATTACH COPIES OF 
SCHEDULE “E”        INVOICES WHEN CLAIMING DEDUCTION.
City of Mobile
Direct Pay Permit              Name of Permit Holder                                               Address                              Total Amount Sold
   Number                                                                                                                               To Each Customer

                                                                                                                                   $
                  - OTHER ALLOWABLE DEDUCTIONS - EXPLAIN FULLY AND QUALIFY WITH COPIES OF INVOICES WHEN
SCHEDULE “F”        CLAIMING DEDUCTION.

                                                                                                                                   $
3. SUMMARY OF DEDUCTIONS
                                                                                               Col. A              Col. B                Col. C                             Col. D
(a) Taxable credit sales made during current month not collected
(b) Total wholesale sales (SALES FOR RESALE) both cash and credit - use SCHEDULE “D”
(c) Sales of lubricating oils and grease
(d) Sales of gasoline (RETAILER COMPLETE SCHEDULE “C” - DISTRIBUTORS COMPLETE
SCHEDULE A-1)
(e) Sales of fertilizer, seeds for planting purposes, baby chicks and poults
(f) Sales of foodstuffs for animal consumption - not including dog and cat food
(g) Sales to U.S. Gov., State of Alabama. Counties and incorporated cities and towns of Alabama
(h) Sales to firms holding a city of Mobile Direct Pay Permit _ must complete SCHEDULE “E”.
(j) Sales of prescription drugs
(l) Credit allowed  for vehicles taken as part payment on sales - trade-ins
(m) OTHER ALLOWABLE DEDUCTIONS - (EXPLAIN FULLY ON SCHEDULE “F”)
4. TOTALS OF DEDUCTIONS - total of each column and enter on front                              $                        $                        $                         $

   DEDUCTIONS NOT DOCUMENTED WILL BE DISALLOWED - - AMOUNT OWED PLUS PENALTY WILL BE ASSESSED






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