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SALES TAX AND TRANSIENT OCCUPANCY TAX RETURN FORM
THIRD QUARTER ENDING: SEPTEMBER 30( July, August, September)
PLEASE FILL OUT AND RETURN THIS FORM SHOWING ANY CHANGES TO THE BUSINESS NAME, INDIVIDUAL NAME OR ADDRESS BY
CROSSING OUT THE OLD INFORMATION AND WRITING IN THE NEW INFORMATION. IF YOU HAVE NOT MADE ANY SALES OR COLLECTED
ANY RENTS OR FEES FOR SERVICES DURING THIS QUARTER, PLEASE INDICATE IN THE APPROPRIATE SPACES AND RETURN THIS FORM
ENTER NAME and ADDRESS: _____________________________________________________
SALES TAX CALCULATION
Gross Receipts - SALES $
Gross Receipts - RENTS $
Gross Receipts - SERVICES $
TOTAL GROSS RECEIPTS $ 0.00
LESS Exempt Sales
Exempt Seniors 65 and above WITH exempt card $
Resale/Wholesale exempt sales $
Single sale amount in excess of $7500.00 $
Sales to State, Federal or Municipal government entity $
Sales delivered outside the City $
Other (MUST describe) $
TOTAL EXEMPT SALES $ 0.00
TOTAL Taxable Sales (Gross Receipts less exempt sales) $ 0.00 .
SALES TAX DUE (.06 x Amount shown on previous line) $ 0.00
TRANSIENT OCCUPANCY TAX CALCULATION
Gross Receipts - TRANSIENT LODGING $
LESS Exempt Transient Occupancy $
Lodging paid on a monthly basis $
Incidental and Isolated rental of private facility $
Rents received from State, Federal or Municipal governments $
TOTAL EXEMPT TRANSIENT OCCUPANCY $ 0.00
Total Taxable Transient Occupancy (Gross receipts less exempt sales) $ 0.00
TRANSIENT OCCUPANCY TAX DUE (.04 X amount on previous line) $ 0.00
TOTAL TAXES DUE (Total sales tax + transient occupancy tax): $ DUE OCTOBER 31
Sales and Transient Occupancy tax returns and payments are due by the end of the calendar month following the close of the sales tax
quarter . Penalties: (1) Within five working days after delinquency date 6%, (2) More than five working days up to and including
thirty days after delinquency date 15%, (3) More than thirty days up to and including sixty days after delinquency date 20%, (4) More
than sixty days after delinquency date 25%
I affirm, subject to the penalties prescribed in the City of Thorne Bay Ordinances that this is a true, correct, and complete sales tax
return.
______________________________________________ SALES TAX NUMBER: ___________________________
Signature of Firm Member, Owner, or Authorized Agent
COMPLETE THIS SECTION ONLY IF THIS IS A FINAL RETURN
Date Business Discontinued ______________________Reason Business Discontinued _____________________________________
Name and Address of Purchaser _________________________________________________________________________________
FOR OFFICE USE ONLY
Date received _____________________ By ____________________ If Mailed, Postmark Date _____________________________
Cash _______________ Check # _________________ Amount Remitted: __________________
CITY OF THORNE BAY P.O. BOX 19110 THORNE BAY, ALASKA 99919
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