Reporting Period                                      Account Number                                                            Due by 

                                                            Combined Sales Tax Return 
Returns & Remittances may be submitted:                                                                                                          CBJ USE ONLY 
      Online at https://beta.juneau.org/finance/sales-tax
      Mail to 155 S. Seward St, Juneau, AK 99801
                                                                                                                                     $ 
      Email to sales.tax.office@juneau.org (returns only)
                                                                                                                                     AMOUNT REMITTED 
      Multiple drop box locations in Juneau                                                                                                  CHECKS PAYABLE TO CBJ 
      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 then sign, date, and submit form timely to avoid late filing fee. 
                                                                                                         Column 1          Column 2                                                     Column 3 
                                                                                                         Areawide Sales  Liquor   Marijuanaor                                           Hotel/Motel 
                                                                                                         5%                Sales 3%                                                     Sales 9% 
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 ordered from outside CBJ and shipped 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 .....................................................................  (                    )  (                          )   (                                                          ) 
4.  NET TAXABLE SALES (Line 1 less line 3) ..........................................  
5.  CALCULATE TAX ................................................................................  
6.  TOTAL TAX (Add line 5, columns 1 and 2. Carry down line 5 column 3)  .............................  
                                                                                                                           (Add Area wide & Liquor   or                                 (Hotel/Motel Tax Only) 
7.  OPTIONAL DISCOUNT IF FILED & PAID TIMELY                                                                               Marijuana Tax)                                               (Amount from Line 5)
    (Calculate 1% of TOTAL TAX line 6, columns 2 and 3, and apply minimums & maximums)
    Column 2: ALL may take $10 minimum. Maximum is $100 for quarterly returns/$50 for monthly returns                    (                       )  (                                                 ) 
    Column 3: ALL may take $10 minimum. Maximum is $100 for quarterly returns/$50 for monthly returns                      (Subject to MIN & MAX.)                                      (Subject to MIN & MAX.)
8. Subtotal amount (Line 6 less line 7, columns 2 and 3)  ...............................................................  
9.  TAX DUE LESS DISCOUNT (Add line 8, columns 2 and 3)  ...................................................................................  
10. Credits from prior periods  Verify credits with the sales tax office before taking .....................................................................   (                                                ) 
11. Late fee  $25 per period ....................................................................................................................................................  
12. Late payment penalty and interest (FOR THIS RETURN ONLY) (See instructions) ....................................................  
13. SUBTOTAL AMOUNT (Summary of lines 9 through 12)  ........................................................................................  
14. Deposits paid .................................................................................................................................................................   (                         ) 
15. TOTAL AMOUNT DUE WITH RETURN (Indicate account number on your check for proper credit) .................  
16. ACCOUNT CHANGES
    A. New Address
    B. Name Change
    C. Business Closure Date                                                                             Consider this filing a final return.   Yes                                       No 
    D. Business Closed or Transferred, please provide the following:
    Sale of Transfer Date:                                            New Owners/Address: 

                                Business Name                                                            Reporting Period                            Account Number 

       CBJ USE ONLY 
17. 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/PRINT NAME/TITLE                                                                        DATE                        CONTACT PHONE #