Reporting Period             Account Number                                Due By 

                                                           Sales Tax Return Form 
                                                                                                                     CBJ USE ONLY 
Returns & Remittances may be submitted: 
   x   eGovern Online at https://juneau.org/finance/sales-tax
   x   Mail to 155 S. Seward St, Juneau, AK 99801                                               $ 
   x   Email to sales.tax.office@juneau.org (returns only)                                        AMOUNT REMITTED 
   x   Multiple drop box locations in Juneau                                                      CHECKS PAYABLE TO CBJ 
   x   In-person at City Hall, 155 S. Seward St

        DO NOT DETACH                                        DO NOT DETACH                        DO NOT DETACH
     CHECK HERE IF NO BUSINESS ACTIVITY THIS PERIOD.  YOU MUST ALSO 
                                                                                                                     Areawide Sales 
     SIGN, DATE AND RETURN FORM TIMELY TO AVOID LATE FILING FEE. 
1.  GROSS SALES:  Do not include sales tax collected or returned merchandise
2.  LESS:  all exempt sales:
    A.  Resale of Goods
    B.  Resale of Services
    C.  Government Agencies
    D.  Goods and Services ordered from outside CBJ and delivered outside CBJ
    E.  Senior citizens with CBJ exemption cards
    F.  Non-profit agencies with CBJ exemption cards
    G.  Other exemptions, specify by code number on lines below:
          --
          --
          --
3.   TOTAL EXEMPT SALES (Total of lines 2A to G)                                                  (                                               ) 
4.   NET TAXABLE SALES (Line 1 less line 3)

5.   SALES TAX     (Multiply line 4 by 5%)
6.   OPTIONAL DISCOUNT IF FILED AND PAID TIMELY                                                   (       2QOLQH )LOHUV 2QO\                      ) 
       $30 flat discount only available for returns filed online with eGovern.                                              (See Instructions)
7.   Credits from prior periods.  Should be verified with Sales Tax Office before applying        (                                               ) 
8.   Late fee ($25)
9.   Late payment penalty and interest (FOR THIS RETURN ONLY)
10.  SUBTOTAL AMOUNT (Summary of lines 5 through 9)
11.  Deposit Summary:          Date Paid                     Tax Due           Deposit Paid 
     A. 1 stmonth of quarter
     B. 2 ndmonth of quarter
     C. 3 rdmonth of quarter
     D. Total deposits paid                                                                       (                                               ) 
12.  TOTAL AMOUNT DUE WITH RETURN (Subtract line 11D from line 10)
13.  ACCOUNT CHANGES
     A. New Address:
     B. Name Change:
     C. Business Closure Date:                                                 Consider this filing a final return.    Yes     No 
     D. Business Sold or Transferred, please provide the following:
        Sale or Transfer Date:                                           New Owners/Address: 

                            Business Name                                      Reporting Period                             Account Number

        CBJ USE ONLY 
14.  I declare subject to the penalties prescribed in City and Borough of Juneau ordinances that this return (including any accompanying
     statements) has been examined by me, and to the best of my knowledge and belief, is a true correct and complete return.

X 
                            SIGNATURE, TITLE                                               DATE                      CONTACT PHONE # 

                               PLEASE REMEMBER TO MAKE A COPY FOR YOUR RECORDS