City of North Pole SALES TAX Remittance Form 
            Payments must accompany tax submission for a complete filing. Tax submissions are for the previous sales 
        month and are due by the last day of the following month by 5 pm (i.e., June sales are filed and paid by July 31). 
                                        Zero sales months still require a filing to be completed. 
 
               Mail To:  THE CITY OF NORTH POLE                     DATE:  __________ 
                125 SNOWMAN LANE 
                                                                    BUSINESS LICENSE NUMBER: _______________ 
                NORTH POLE, AK 99705 
     Phone:      907-488-8536                                       BUSINESS NAME: ___________________________ 
     Online Filing: www.xpressbillpay.com                            
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           Check here if your physical address or phone number          has changed, or if the business is closing.  
             Note changes on the back of this form. New owners must apply for a business license. 
  
     1.      Gross Sales for Month Ending:                                                        $                   
  
     2.      Credit Card Service Fees                                                             $                   
  
     3.      Non-Taxable Sales (see chp.4, Sec. 4.08.020 & 4.08.050 of North Pole Code)  $                            
  
     4.      Gross Taxable Sales                                                                  $                   
             (Subtract lines two and three from line one) 
  
     5.      Sales Tax Due (5.5% of     line four     ) ($16.50 cap per transaction)              $                   
  
     6.      Fees: (Calculate the following charges based on line five) 
  
             a.          Returns 1 - 29 days past due add $25 or .00875 of sales tax 
                         due, whichever is greater, in addition to the total amount due 
                         .   Incomplete returns add a penalty of $15.                             $                   
  
             b.          Returns 30- 60 days past due add $50 or .00875 of sales tax due, 
                         whichever is greater, in addition to all previous fees and penalties.    $                   
                         Incomplete returns will incur an additional penalty of $15. 
  
             c.          Returns 61 days past due will incur a reoccurring monthly fee of 
                         $50 in addition to all previous fees, and interest. Sellers failing to 
                         file complete returns & full remittance will be subject to revocation of 
                         their business license and a lien against the seller’s property will be 
                         administered.                                                            $                   
  
     7.      TOTAL FEES DUE                                                                       $                   
  
     8.      TOTAL SALES TAX/FEES DUE                                                             $                   
             (Add lines 5,6 & 7 to show the amount here) 
  
     Interest at the rate of 10.5% per annum, applied monthly, shall accrue on all delinquent taxes & fees 
     starting from the due date until paid in full. 
  
     I DECLARE, SUBJECT TO THE FEES PRESCRIBED, THAT THIS RETURN (INCLUDING ACCOMPANYING STATEMENTS) 
     HAS BEEN EXAMINED BY ME, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IS A TRUE, CORRECT, AND 
     COMPLETE RETURN. 
  
     DATE:                              OWNER/AGENT:                                                            
  
   PHONE: _________________               EMAIL: ____________________________________________________________ 
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