Reporting Period            Account Number                                 Due By 

           A                                                              
                                                                                                     
                                                                                                     CBJ USE ONLY 
                                                                                             
                                                                                            $    
                                                                                                AMOUNT REMITTED 
Finance Department, Sales Tax Division                                                          CHECKS PAYABLE TO CBJ 
155 So. Seward St, Juneau, AK  99801       
ANNUAL SALES TAX RETURN FORM                                                                 

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 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 (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                                                     (                                   ) 
       Subject to minimum and maximum.  See instructions                                           (Subject to minimum & maximum) 
7.   Credits from prior periods.  Should be verified with Sales Tax Office before applying          (                                   ) 
8.   Late fee ($25)                                                                                  
9.   Late payment penalty and interest                                                               
10.  SUBTOTAL AMOUNT (Summary of lines 5 through 9)                                                  
11.  Deposit Summary:                   Date Paid          Tax Due               Deposit Paid      
        st
     A.  1  month of quarter                                                                       
        nd
     B.  2  month of quarter                                                                       
        rd
     C.  3  month 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 
                                                                                                      
     I declare subject to the penalties prescribed in City and Borough of Juneau ordinances that this return (including any accompanying 
14.  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 # 
 
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