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                                                         CITY OF UNALASKA
                                                    PO BOX 610 UNALASKA, AK 99685
                                                Phone (907) 581-1251     Fax (907) 581-1417 
                                                           www.ci.unalaska.ak.us

                                                         SALES TAX REPORT
                          QTR1 o          QTR2 o                    QTR3 o                    QTR4 o
     QTR ENDING          March 31             June 30            September 30            December 31                                              YEAR __________________
                       DUE April 30       DUE July 31            DUE October 31          DUE January 31 
            Beginning with 2022 Q4 Report due 1/31/2023, a $25 per month late filing fee will be assessed, even for zero sales reports.
     BUSINESS NAME:                                                                      BUSINESS LIC. #
     ADDRESS:
                                                                                                     Final Report, Close Business License        o

     DETERMINATION OF ADJUSTED GROSS RECEIPTS
        1.  GROSS RECEIPTS FOR QUARTER (INCLUDING   SALES TAX COLLECTED)
            A.    RENTALS . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $ ____________________
            B.    SALES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ____________________
            C.    SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ____________________
            D.  TOTAL GROSS RECEIPTS (Add A through C)     . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . .              $ _______________________
        2.  NON-TAXABLE RECEIPTS (Complete Page 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________________
        3.  ADJUSTED GROSS RECEIPTS (Subtract Line 2 from 1D)       . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . $ _______________________

     DETERMINATION OF TAXABLE RECEIPTS
        4.  DIVIDE LINE 3 BY 1.03 (TAXABLE GROSS RECEIPTS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________________

     DETERMINATION OF TAX DUE
        5.  MULTIPLY LINE 4 BY .03 – SALES TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________________
        6.  CREDIT OR AMOUNT DUE FROM PREVIOUS REPORTS . . . . . . . . . . . . . . . . . . . . .  . . . . . . . . $ _______________________
        7.  CREDIT FOR SALE FOR RESALE REFUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________________
        8.  TAX DUE (Line 5, plus or minus Line 6, minus Line 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $ _______________________
        9.  PENALTY AND INTEREST DUE (If applicable)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . . .  $ _______________________
     10.    TOTAL DUE (Line 8 plus Line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _______________________

     Sales Tax Reports due quarterly on the last day of the month following the end of a quarter. Report invalid unless completed in 
     detail and signed. Report required even if there were no receipts for the quarter. Delinquent reports incur a $25/mo. late fee up
     to $100 ;5% penalty/mo. or fraction thereof up to 20%   ; &15% interest per annum. Failure to file is a minor offense with the 
     fines established by code up to $500 per violation or day. The City’s additional remedies for violations of sales tax ordinances 
     are set out in Unalaska Code of Ordinances 6.40.100.

     I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT.

     SIGNATURE                                                 TITLE                                                                         DATE

     PRINTED NAME                                                EMAIL ADDRESS

            COMPLETED SALES TAX REPORT MAY BE EMAILED TO CITY CLERK'S OFFICE                                AT   tax @ci.unalaska.ak.us
                                                                                                                                             Revised 07/18/2023



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                  CITY OF UNALASKA SALES TAX REPORT

Name                                                                           Quarter Ending: ____________________

License #

                             NON-TAXABLE TRANSACTIONS

1.  SALES TO CITY OR OTHER GOVERNMENT AGENCIES 6.40.030(L)                                                          $ __________________________
         SOLD TO:                                                                                                   AMOUNT:
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________

2. SALES RELATED TO CITY PUBLIC WORKS PROJECTS 6.40.030 (AA)                                                        $ __________________________
         SOLD TO:                                                                                                   AMOUNT:
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________

3. SALES NOT "MADE IN THE CITY" 6.40.010(C)                                                                         $ __________________________
         SOLD TO & LOCATION:                                                                                        AMOUNT:
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________
         _________________________________________________________                                                  _________________________

4.  ALL OTHER SALES CLAIMED EXEMPT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                    $ __________________________
                                      City Sales Tax Exemption Certificate Number 
                                                                               or other justification
         SOLD TO:                                                                                                   AMOUNT:
         ______________________________         ______________________________                                      _________________________
         _____________________________         _______________________________                                      _________________________
         _____________________________         _______________________________                                      _________________________
         _____________________________         _______________________________                                      _________________________

TOTAL ALL NON-TAXABLE TRANSACTIONS                                             . . . . . . . . . . . . . .          $ __________________________






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