SALES TAX AND TRANSIENT OCCUPANCY TAX RETURN FORM 

                         FIRST QUARTER ENDING:  March 31                        (January, February,March) 
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 April 30th
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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