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                      Wyoming Department of Revenue 
                Sales & Use Tax Return for Licensed Vendors 
                  Form 41 (monthly & quarterly filers)   
 
Important Information                              Please ensure that you sign and date the 
                                                   form      before submitting     to         the 
 All  returns  must  be  postmarked  by  the      department.  Any    unsigned               or 
  last day of the month following                  incomplete tax returns will be rejected 
      the last month in the reporting period.  
                                                   and  a  new  return  will  be  sent  to  the 
  i.e. Report period 8/1/09 through 8/31/09    
                                                   vendor  for  completion.    The  new 
  postmarked by 9/30/09.     
  If the last day of the month falls               return  must  be  completed  in  its 
  on  a  weekend  or  holiday  the                 entirety,  and  the  return  must  be 
  returns  must  be  postmarked  by                signed.   
  the following business day.                        
 
                                                    Part – I- Summary 
 Please  make  a  copy  of  this  return  for 
  your records. 
                                                   
                                                  Line A.  Enter the total amount of all sales, 
 You must file a return even if there were 
                                                  leases,  rentals  and  services  made  by  your 
  no sales or taxes to report. 
                                                  business  for  the  reporting  period.    Include 
 
                                                  sales  made  to  yourself;  this  includes  all 
 Submit  completed  returns  and  payment        inventory  purchases that            were 
  to:                                             used/consumed by you.  Do not include the 
  Wyoming Department of Revenue                   amount of sales tax collected or the amount 
                nd
  Herschler Bldg. 2  Floor West                   of use tax due on purchases on this line.   
  Cheyenne, WY 82002-0110                          
                                                  Line  B.   Enter  the  total  amount  of 
 If  you  are  filing  an  amended  return,      deductions  for  the  reporting  period.    This 
                                                  would  include  sales  or  services  that  are 
  please  check  the  box  at  the  top  of  the 
                                                  exempt  from  tax  and  supported  by  a 
  form  under  the  return  due  date  to         Streamlined  Sales/Use  Tax  Agreement 
  indicate this is an amended return.             Certificate  of  Exemption  or  a  Direct  Pay 
                                                  Permit  and  sales  or  services  that  are  not 
 Please  do  not  use  dashes  for  numbers,     subject to tax.   
  punctuation  such  as  decimals,  commas,        
                                                  Line C. Subtract the total deduction amount 
  dollar signs etc. on the returns.   
                                                  (line  B)  from  the  gross  sales  and  services 
    
                                                  amount  (line  A)  and  enter  the  difference.   
 If  you  made  no  sales  at  all  during  this This  figure  represents  the  amount  of  sales 
  filing period and you owe no use tax on         which are subject to sales tax.  
  purchases,  please  check  the  box              
                                                   
  indicated for no sales or taxes to report.  

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Skip to Part II Jurisdictional Tax               Column 3:    Enter the tax rate in effect for 
                                                 the reporting period for the jurisdiction you 
Information                                      are reporting sales in or use tax is owed in.  
                                                 (Refer to the current sales/use tax rate chart 
This section is used to itemize sales/use tax    on our website.)   
to the jurisdiction where the sale or delivery    
took  place.  All  sales/use  tax  due  will  be Column 4:   Enter the total amount of sales 
reported  using  only  the  county  level        tax  due  for  the  jurisdiction  entered  in 
jurisdiction name and digit code, as sales       column 1.   
and  use  tax  is  only  imposed  at  the  state  
and  county  level.    Example:    Natrona       Column  5:   Enter  the  total  amount  of use 
County,  jurisdiction  name  code  to  be        tax  due  for  the  jurisdiction  entered  in 
entered  NATR.    Jurisdiction  digit  code  to  column  1.    Use  tax  is  due  on  items 
be entered (County/City code) 0100.              purchased  out  of  state  and  brought  into 
                                                 Wyoming  for  storage,  use  or  consumption, 
If the tax jurisdiction name, digit code and     where no tax or not enough tax was charged 
tax rate is not pre-printed or is incorrect on   by the vendor at the time of purchase.  This 
your  return,  please  enter  the  correct       would include items such as office supplies, 
jurisdiction  name,    digit code       and      cleaning  supplies,  etc;  items  that  will  be 
corresponding  tax  rate,  in      Part II       used/consumed by your business.  Use tax is 
Jurisdictional Tax Information.                  not  due on inventory purchases  made from 
                                                 out  of  state  suppliers  that  you  intend  to 
If  additional  room  is  needed,  complete      resell.  Do  not  include  the  purchases 
Part III Supplement (form 41-2)                  subject to this tax on Line A (Gross Sales 
                                                 and Services) of the return. 
Column  1:  Enter  the  four  letter              
jurisdictional  name  code  for  the  first      Column 6:  Enter the total amount of excess 
jurisdiction you made sales in or owe use tax    tax  due  for  the  jurisdiction  entered  in 
in for purchases made out of state where no      column  1.    This  would  include  any  over 
tax  or  not  enough  tax  was  paid  on  your   collected tax due to calculation errors and or 
taxable purchases.  Example:  Tax owed in        rate collection errors. 
Laramie County Wyoming, enter      LARA in        
this column.  (Refer to the Jurisdiction Code    Column  7:   Add  columns  4,  5,  and  6  and 
Table.)                                          enter the total.   
                                                  
Column 2:    Enter the four digit jurisdiction   Repeat  steps  listed  for  Column  1  through 
digit  code  (this  is  the  combined  County    Column 7 for each jurisdiction in which tax 
Code  and  City  Code  from  the  jurisdiction   is due.   
table) which corresponds to the jurisdiction      
name  code  you  entered  in  column  1.         Line K:   Add net tax due totals in column 7 
Example:  Tax  owed  in  Cheyenne,  WY           on form 41-1 and place sum here.   
(Laramie County) enter 0200. (Refer to the        
Jurisdiction Code  Table.)   Note:    The  last  If  additional  space  is  needed  to  report  for 
two  digits  (city  code)  will  always  be  00  additional jurisdictions, please complete part 
unless reporting lodging tax, or reporting       III Jurisdictional Tax Information on Form 
resort district tax.                             41-2.    This  form  is  completed  the  same  as 
                                                 the above steps.  Total  all Net  Tax Due in 

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Column 7 and enter the sum in Line 1 at the       located.   Example:  Lodging  establishment 
bottom of the Form 41-2.                          located  within  the  municipal  boundaries  of 
                                                  Cheyenne, WY the Jurisdiction Name code 
Line  L:   If  you  reported  tax  due  for       to  enter  in  Column  1  on  the  form  41-3 
additional jurisdictions on Form 41-2, place      would  be  CHEY.   The  Jurisdiction  Digit 
the total from Line 1 here.  Please indicate      code to be entered in Column 2 on the form 
the number of supplemental pages included         41-3 would be 0201.   
with this form in the box to the left of this      
line.                                             For a lodging establishment located outside 
                                                  of  the  municipal  boundaries  of  the  City  of 
Line M:  Add lines K and L and place total        Cheyenne, WY the Jurisdiction Name code 
here.  This should be the total sales/use and     to enter in Column 1 of the form 41-3 would 
excess tax due for this reporting period.         be LARA.    The  Jurisdiction  Digit  code  to 
                                                  enter in  Column 2 of the form  41-3 would 
If  you  are  not  a  lodging  vendor  in  a      be 0200.   
jurisdiction  that  has  enacted  a  lodging       
tax,  skip  to  Line  D  Part  I  Summary  on     If your lodging establishment is located in a 
Form 41-1 instructions.                           County  where  only  specific  cities/towns 
                                                  have  enacted  a  lodging  tax  and  your 
                                                  establishment  is  not  located  within  the 
Form  41-3  Supplement  for                       municipal boundaries of the city/town with a 
                                                  lodging tax you are not required to report on 
Lodging Vendors.   
                                                  a  form  41-3.   Example:  A  lodging 
                                                  establishment  located  in  Basin,  WY  (Big 
If  you  are  a  lodging  vendor  and  your       Horn  County)  would  not  complete  a  form 
lodging  establishment  is  located  in  a        41-3 as this establishment is not located in a 
jurisdiction that has enacted a lodging tax       city/town with a lodging tax enacted.   
you  must  complete  Form  41-3  Part  IV          
Lodging    Tax Information,   before              Column  1:       Enter  the  four  letter 
proceeding.    Lodging  vendors  will  be         jurisdictional  name  code  for  the  first 
reporting the lodging tax rate only on the        jurisdiction  that  lodging  tax  is  owed  for.  
Form 41-3.  Example:  Lodging tax due for         Example:  Hotel located in Sheridan County 
a  hotel  located  within  the  City  limits  of  within the City of Sheridan, enter SHRD in 
Sheridan, WY.  The lodging tax rate to  be        this column.  Note:  The jurisdictional name 
reported on 41-3 is 4%.                           code to be used to report lodging tax will be 
                                                  the  City  or  Town  where  the  lodging 
If your lodging establishment is located in a     establishment is located.  Example:     Hotel 
jurisdiction that has enacted a lodging tax, at   located  within  the  city  limits  of  Cheyenne, 
the county level and you are located within       WY jurisdiction name code to be entered is 
the municipal boundaries of an incorporated       CHEY.   
city or town in  that  county  you  will report    
your  lodging  tax  to  that  city/town           Column 2:  Enter the four digit jurisdiction 
jurisdiction.  However if your establishment      digit  code  which  corresponds  to  the 
is  not  located  within  the  municipal          jurisdiction  name  code  you  entered  in 
boundaries of an incorporated city/ town you      column  1. Example:   Lodging  tax  owed  in 
will  report  your  lodging  tax  to  the  county the  City  of  Sheridan,  enter  0304  in  this 
jurisdiction  where  the  establishment  is       column.    Note:    The  four  digit  jurisdiction 

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digit  code  to  be  used  to  report  lodging  tax tax due for this period, from Line 1 Part IV 
will  be  the  code  which  corresponds  to  the    Lodging Tax Information Form 41-3.  
location  of  the  establishment.    Example:        
Hotel  located  within  the  city  limits  of       Line F.  Enter the total of all tax due for this 
Cheyenne, WY four digit code to be entered          period.    Add  lines  D  and  E  and  place  the 
is 0201.                                            sum in Line F.   
                                                     
Column  3:   Enter  the  lodging  tax  rate  in     Line G.  This line is only to be used if the 
effect  for  the  reporting  period  for  the       return  and  payment  are  going  to  be 
                                                                             th
jurisdiction  you  entered  in  column  1.          postmarked by the 15  of the month the 
Remember this is only the lodging tax rate          tax is due.  Example:  January 2012 return 
not  the  total  combine  rate  for  sales  and     and  payment  must  be  postmarked  by 
lodging  tax.    (Refer  to  the  current           February 15, 2012 to qualify for the vendor 
sales/use/lodging tax rate chart.)                  compensation credit.     
                                                     
Column  4:   Enter  the  total  amount  of           Enter  the  total  amount  of  vendor 
lodging tax due on lodging services for the         compensation  credit  allowed  for  the  filing 
jurisdiction entered in column 1.                   period.  Note:  Vendors are allowed to take 
                                                    a credit of 1.95% of the total tax due for the 
Repeat steps listed for Columns 1 through 4         first $6250.00 of tax due.  For any amount 
above  for  each  jurisdiction  you  need  to       exceeding $6250.00 of tax due vendors are 
report lodging tax.                                 allowed  to  take  a  1%  credit,  up  to  a  total 
                                                    vendor  compensation  credit  of  $500.00  per 
Total  all  tax  due  on  lodging  services  in     filing  period,  per  vendor  (vendor  means 
column 4 and enter the sum in Line 1 at the         ownership).  To  calculate  the  vendor 
bottom of the Form 41-3.                            compensation  credit,  follow  the  example 
                                                    below:   
Line  D  Part  1  –  Summary  on                     
                                                    Assuming total tax due of $7,500.00 for the 
Form 41-1 
                                                    January 2012 filing period, (from line F of 
 
Line  D.     You  must  complete  Part  II          Part 1- Summary on Form 41) 
Jurisdictional  Tax  Information  and  Part  III 
                                                    1.95% X $6,250.00 = $121.88  
(form  41-2)  Jurisdictional  Tax  Information 
Supplemental  page  (if  applicable). Enter 
                                                    1%  X  $1,250.00  (amount  exceeding 
the total amount of sales, use and excess 
                                                    $6250.00) = $12.50.   
tax due for this filing period from Line M 
Part  II  Jurisdictional  Tax  Information 
                                                    $121.88 + $12.50 = $134.37 
Form 41-1 
                                                    The  total  vendor  compensation  credit 
Line E.    If you are not a lodging vendor or 
                                                    allowed for the January 2012 filing period is 
your  lodging  establishment  is  located  in  a 
                                                    $134.37.  Place this amount on line G.   
jurisdiction that does not have a lodging tax 
enacted, please enter zero here.   
                                                    For  additional  information  an  eligibility 
If  you  are  a  lodging  vendor  and  located 
                                                    requirements please see the December 2011 
within a jurisdiction which has lodging tax 
enacted,  enter  the  total  amount  of  lodging    Taxing  Issues,  which  is  available  on  our 
                                                    website at http://revenue.state.wy.us  
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Line H.    Enter the total amount of penalty,         
interest  and  department  billings  notices.          
Penalty for paying tax after the due date is          
                                                      
10%  of  the  total  tax  due.    Penalty  for  not 
                                                      
filing the return by the due date is $10.00.  If 
                                                      
the return is not filed within the next thirty        
days  an  additional  penalty  of  $25.00  is         
assessed.    Interest  is  calculated  at  a  daily   
rate.  Interest rate information is on our web        
site.    If  you  have  received  a  billing  notice  
                                                      
from the department that is unpaid, include 
                                                      
this amount here.                                     
                                                      
Line  I:   Enter  the  amount  of  any  Credit 
                                                      
Notice  you  have  received  from  the 
                                                      
department.   Note:  Do  not  enter  a  credit 
                                                      
amount here until you have received notice 
                                                      
from the department as this could cause an 
                                                      
underpayment of your return.   
                                                      
Line  J:   Subtract  line  G  from  F,  Add  the 
                                                      
figures  in  Line  H  then  subtract  figure 
                                                      
entered in line I, enter the sum here.   This  is 
                                                      
the total amount of tax due for this reporting 
                                                      
period.                              
                                                      
If  your  business  has  had  informational 
                                                      
changes pertaining to address, ownership, or 
                                                      
contact  information  please  attach  an 
                                                      
additional page indicating the changes.     
                                                      
Please sign and date the return.               
                                                      
                                                       Instructions form 41 issued 12/30/2011 
 
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