SALES & USE TAX
                                              MONTHLY TAX RETURN

                                                                                                                                            MONTH COVERED BY THIS REPORT
                                                                                                                           OR 
                                                                                                                                            PERIOD COVERED BY THIS REPORT
                                          www.cityofmobile.org/html/departments/revenuewww.cityofmobile.org/revenue12               From:                                             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) 208-7461
                            FIGURES MAY BE ROUNDED TO NEAREST DOLLAR

   Is this a final return  � Yes   � No.         If yes, attach explanation and date closed _____/_____/_____

                                                                                                 TAX DUE AT CITY RATE                       TAX DUE AT P/J RATE

1. Gross Sales/Use Tax                                                                           Col.Col.AA--5%4%          Col.Col.BB-2%             - 2.25% Col.Col.CC-2%           - 2.5% Col.Col.D-1%D - 1.125%
(A) Gross sales of new and used vehicles, semi-trailers
   and truck trailers.
(B) Gross sales of machines and replacement parts used
   in manufacturing process.
(C) Gross sales from places of amusement.
(D) Fair market value of properly purchased at wholesale
   withdrawn for use or otherwise disposed of.
(E) Retail selling price of property used within the City or
   PJ on which Mobile tax has not been paid.
(F) Gross sales of liquid fuel, gaseous fuel and/or any other
   fuel for use both on and off highways.
(G) Gross sales of beer, liquor, wine and/or other alcoholic
   beverages.
(H) Gross sales from all business not included above.
(I) Collections made during month on credit sales
   heretofore claimed as deductions on sale of receivables.
2. TOTAL OF EACH COLUMN
(Lines A,B,C,D,E,F,G,H & I above)
LESS: TOTAL DEDUCTIONS-LINE 4 ON REVERSE SIDE
5. TOTAL OF AMOUNTS REMAINING AS MEASURE OF
TAX each column, line 2 minus line 4 from Reverse Side
6. AMOUNT OF TAX Each column (Line 5 x Applicable rate
shown at top of column).
7. Number of new vehicles withdrawn
         ____________ x $5.00 (Col.B) CITY
         ____________ x $2.50 (Col.D) PJ
8. AMOUNT OF TAX - Each Col.
9. Add ______________% Penalty - (SEE BELOW*)

10. TOTAL EACH COL.                                                                              $                          $                         $                                  $

                             TOTAL PAYMENT ENCLOSED WITH THIS REPORT
                                                                                                                                            $

IF BUSINESS NAME IS IMPRINTED,THIS RETURN MAY BE USED ONLY BYTHE BUSINESS NAMED.
                                                                                                                           *PENALTY                          OF  5%  PER  MONTH
                                                                                                                           WHEN             PAID                      AFTER                 20TH            OF
         Account Number:                  -                                                                                MONTH  FOLLOWING  THE  PERIOD
                                                                                                                           COVERED.
                                                                                                                           This  report, including  accompanying  schedules  or
                                                                                                                           statements, has  been  examined  by  me  and  is  to  the
                                                                                                                           best  of  my  knowledge  and  belief, a  true  and 
________________   __________________________________________   _______________________________                            complete  report  made  in  good  faith  for  the  period
Date                   Signature                                                           Title                           stated.
                                                                                                                                                                                                      REV. 5/11/2010REV. 9/3/2008

                                                  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