Montgomery County, Alabama

                                       Sales Tax                     Seller's Use Tax          Consumer's Use Tax                                       Education Only Tax
                                                                                               *MAIL RETURN WITH REMITTANCE TO:
                             Tax Period                                                        Montgomery County Commission, Tax & Audit Department
                                                                                               P. O. Box 4779  Montgomery, AL  36103-4779
Check here for any changes in business              and complete lower portion of back side
                                                                                                                                       RETURN DUE
                                                                                                                 Monthly filers should file each calendar month on or 
                                                                                                                 before the 20th of the following month even though 
                                                                                                                 no tax is due.

                                                                                                                 Make check payable to:
                                                                                                                 Montgomery County Commission

                                                                                               TOTAL AMOUNT ENCLOSED

                                                                                                                 $

                                                                      (A)                  (B)                                 (C)                (D)                               (E)
     Type of Tax/Tax Area                           Gross Taxable Amount                   Total Deductions         Net Taxable               Tax Rate                              Gross Tax Due
                                                                                                                               (A - B)                                              (C x D)
SALES TAX                                                                                  (Discount Allowed:  Max. $400.00 per filing period)
  a. Automotive/Agricultural
    Manufacturing                                                                                                 $                         0.333%                                 $
  b. Vending Machines                                                                                                                       1.250%
  c. General                                                                                                                                2.500%
  d. Education only
     Auto/Agricultural/Manuf                                                                                                                0.133%
  e. Education only
    General                                                                                                                                 1.000%
SELLERS USE TAX                                                                            (Discount Not Allowed)
  a. Automotive/Agricultural
    Manufacturing                                                                                                 $                         0.333%                                 $
  b. General                                                                                                                                2.500%
  c. Education only
     Auto/Agricultural/Manuf                                                                                                                0.133%
  d. Education only
    General                                                                                                                                 1.000%

CONSUMERS USE TAX                                                                          (Discount Not Allowed)
  a. Automotive/Agricultural
    Manufacturing                                                                                                 $                         0.333%                                 $
  b. General                                                                                                                                2.500%
  c. Education only
     Auto/Agricultural/Manuf                                                                                                                0.133%
  d. Education only                                                                                                                         1.000%
    General
* Deductions are to be itemized on back of form.
                                                                                                                  (1) TOTAL TAX DUE
* If total tax due is $500 or more, online filing & payment required.                                               (Total of column E)                                            $
*** Interest through July 31, 2017: (Item 1 x 1% per month delinquent)                                            (2) PENALTY Late Filing 
       Interest after August 1, 2017: (Then-prevailing rate published in IRC 6621 Table of                        Fee:Minimum of $50 or 10% of taxes 
          Underpayment Rates / 365 = Daily rate x No. of days late)                                               due.  Late Payment:  10% of tax.
* All returns or correspondence should be mailed as noted (*) above.                                              (3) INTEREST
* Walk-in filing may be done at the following location: 101 South Lawrence Street                                 ***See information to left
*  For questions or assistance phone (334) 832-1697 or send email to: TaxAudit@mc-ala.org                         (4) DISCOUNT - on Sale Tax Only
    By signing this report I am certifying that this report, including any accompanying                           If paid on time, 5% on first $100 or 
    schedules or statements, has been examined by me and is to the best of my                                     less plus 0.75% on tax over $100. max 
    knowledge and belief a true and complete report for this period stated.                                       $400 allowed.
Date                                                Title                                                         (5) NET TAX DUE
                                                                                                                  Item (1) + Item (2) & (3) or (1) -( 4)
Signature                                                                                                         No. of automotive vehicles ________ 
                                                                                                                  withdrawn @ $5.00 each
Printed Name:                                                                                                     TOTAL AMOUNT ENCLOSED                                            $
                                                                                                                  If total payment is $500 or more, online filing/payment required.

Use tax  is the counterpart of sales tax and should be paid by individuals or businesses when making purchases outside
the county of Montgomery on taxable items for which a sales tax was not collected by the seller.  The use tax applies 
to
SELLERS USE/SALES TAX:

  a. Automative/Agricultural:  Include new and used automotive vehicles, semi-trailers, truck trailers, house 
     trailers, and agricultural machinery.
   Manufacturing:  Machines and replacement parts used in manufacturing etc.
  b. Vending Machines:  Retail price of food products sold for human consumption thru vending machines.
  c. General:  Includes gross receipts from places of amusement; cost of property at wholesale withdrawn
     for use; collections during the month on credit sales previously claimed as deductions; and all 
     other sales of tangible personal property not previously claimed.
CONSUMER'S USE TAX

  a. Automotive/Agricultural:  Total purchase price of automotive vehicle, truck trailers, semi-trailers, house
     trailers and agricultural machinery, both new and used purchased for storage, use or other consumption in
     Montgomery County on which seller has not collected Montgomery County Sales and /or Use Tax.
     Manufacturing:  Total purchase price of machines and replacement parts used in compounding, mining, 
     quarrying, manufacturing of tangible property.
  b.  General:  Total purchase of tangible personal property purchased outside of Montgomery County or
     in Interstate Commerce for storage, use or comsumption in this county on which seller has not collected
     use tax from you except purchases of automotive vehicles, truck trailers, semi-trailers, house trailers,
     agricultural machinery, and machines and replacement parts.

                                                    STANDARD DEDUCTION SUMMARY TABLE
                                 (Summary below must be completed to correspond with total deductions on front of tax report)
Type of Tax       Wholesale       Automach          Labor/non         Sales deliv.                    Sales to govt      Sales of gas           Other     Total
                   Sales                  trade-ins taxable serv      outside juris                   or its agencies    or lube oils           allowable deductions
                                                                                                                                                deductions

  Totals

                  INSTRUCTIONS & INFORMATION CONCERNING THE COMPLETION OF THIS REPORT
     *  To avoid the application of penalty and/or interest amounts, this report must be filed on or before the 20th of the month, following the
        period for which the report is submitted.  Cancellation postmark will determine timely filing.
     *  A remittance for the total amount due made payable to the taxing jurisdiction must be submitted with this report.
     *  This report should be submitted on a monthly basis unless you have requested and been approved for a different filing frequency by 
        this taxing jurisdiction.
     *  Any credit for prior overpayment must be approved in advance by the taxing jurisdiction and accompanied by a letter of credit from
        the taxing jurisdiction.
                                                    Indicate Any Account Changes Below
Business Name:                                                                                        Date of Change:
Physical Address:                                                                                     Phone:
Mailing Address:                                                                                      FAX:
                                                                                                      Contact Person:

                                                                      Final Report
Give Date Business Closed:
Successor's Name:
Address: