Quarter Ending    Due 
                 QUARTERLY SALES TAX RETURN                                                                                                                                       st  April 30 th
                                                                                                                                                                    ☐
                 City and Borough of Wrangell                                                                                                                        March 31
                 PO Box 531                                                                                                                                          June 30th        July 31 st
                                                                                                                                                                    ☐
                                                                                                                                                                    ☐ Sept. 30th      Oct. 31 st
                 Wrangell, AK 99929                                                                                                                                 ☐ Dec. 31  st     Jan. 31st 
                                                                                                                                                                    For Year: ____________________
The tax imposed under Wrangell Municipal Code 5.08.090(c) shall be payable at the end of each quarter and due not later than one month after 
this date (see above for dates).  Payments, including those received in the City Hall drop box, must be received by 5:00 PM on this due date.  
Payments postmarked on the due date will be accepted as paid on time. 

      Name                                                            E-mail
      DBA                                                             Phone
      Street 
   City, ST, Zip                                                      Customer Number
GROSS REVENUES ONLY – DO NOT INCLUDE SALES TAX COLLECTED IN GROSS                                                                                                                    AMOUNT 

1. SALES   .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .   .    .    .    .    .    .    .     1 
2. SERVICES RENDERED (including materials) .    .    .    .    .    .    .    .    .    .    .    .   .    .    .    .    .    .    .                                 2 
3. RENTALS .    .    .    .    .    .    .    .    .    .    .    .   .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .    .   .      3 
4. ALL OTHER SOURCES  .    .    .    .    .    .    .    .    .    .    .    .   .    .    .    .    .    .    .    .    .    .    .    .    .    .                   4 
5. TOTAL REVENUES (SUM OF LINES 1 THROUGH 4) .    .    .    .    .    .    .    .    .    .    .    .   .    .    .    .                                             5                      0.00

EXEMPTIONS – See Wrangell Municipal Code 5.08.050, available online at http://www.codepublishing.com/AK/Wrangell/ 
 6.   AMOUNTS OF SINGLE PURCHASE SALES EXCEEDING $3 0 , 00.00  .    .    .    .    .    .   .    .    .    .    .                                                       6 
      Invoices for sales of services shall be computed monthly or less for tax purposes.
7.    SALES TO U.S. GOVERNMENT, STATE OF AK, OR MUNICIPAL GOVERNMENT.    .   .    .    .    .    .                                                                    7 
8.    SALES TO RETAILER FOR RESALE, OR LICENSED CONTRACTOR FOR USE IN CONSTRUCTION                                                                                    8 
9.    SALES ON TAX FREE DAY(S)  .    .    .    .    .    .   .    .    .    .    .    .    .    .    .    .   .    .    .    .    .    .    .                         9 
10.   OTHER EXEMPTION(S) - SPECIFY WHICH:  ________________________________________                                                                                  10 
11. TOTAL EXEMPTIONS (SUM OF LINES 6 THROUGH 10) .    .   .    .    .    .    .    .   .    .    .    .    .    .                                                    11                     0.00
12. NET TAXABLE REVENUE (LINE 5 MINUS LINE 11)  .    .   .    .    .    .    .    .   .    .    .    .    .    .    .    .                                           12                     0.00

                                                                                                                                                                                            0.00
13. 7% TAX DUE (LINE 12 MULTIPLIED BY 0.07)  .    .   .    .    .    .    .    .   .    .    .    .    .    .    .    .    .                                         13 

All penalties and interest are applied uniformly and without waivers or exceptions, regardless of the tax amount due, unless approved by the 
Borough Assembly to be waived based upon demonstration of a medical reason that prevented the timely filing. 
Penalties and Interest for Late Returns – Wrangell Municipal Code 5.08.100 
                    0-1 month late            1-2 months late                 2-3 months late                                                                         3 or more months late 
    Penalty Total           5%                  10%                                15% (max)                                                                                15% (max) 
    Interest Total          -                   1.25%                                   2.5%                                                                        +1.25% per additional month

Date:                             Signature: 
                                                                         Firm Member, Owner or Agent 
By signing above, you declare that the information in this document and any attachments is true and correct to the best of your knowledge. 

Borough Finance Department Notes: