Taxpayer Name and Address 
                                                                                  TOWN OF CASTLE ROCK SALES TAX RETURN 

                                                                                  Mail To:   Sales Tax Division                         Email:   towntax@crgov.com 
                                                                                        PO Box 17906                                    Phone:    (303) 660-1397 
                             YOU MUST  ILE  F HIS T ETURN R VEN EF  INEI L     12       Denver, CO  80217                                Fax:       (303) 660-5310 
PERIOD COVERED                     DUE DATE                          LICENSE #                   This return may be filed over the internet at: 
                                                                                                                 www.crgov.com/tax 

                                                                     COMPUTATION OF TAX 
    GROSS SALES AND SERVICES: (BEFORE SALES TAX)                   MUST
1.         BE REPORTED INCLUDING ALL SALES RENTALS,   LEASES, AND,             $       5.        NET SALES TAX   (LINE  X4 4.0%)                           $
           SERVICES,BOTH TAXABLE AND NON TAXABLE-
2A.    ADD BAD DEBTS COLLECTED WHICH WERE PREVIOUSLY DEDUCTED:                 $       5 .a      SALES AMOUNT SUBJECT TO LODGING TAX                       $
2B.                                                           ADD LINES 1 & 2A $       5 .b      LODGING TAX (LINE 5a X 6%)                                $
                                                                                       6.        ADD EXCESS TAX COLLECTED                                  $
3.  A. NON TAXABLE- SERVICES OR LABOR                                          $
                                                                                       7.        NET ADJUSTED SALES TAX   (ADD LINES 5, 5b  & 6)           $
    B. SALES TO OTHER LICENSED DEALERS  ORFPURPOSES OF TAXABLE RESALE          $
                                                                                                 DEDUCT3.33% OF LINE7 (ENTER 0IF RETURN IS FILED LATE ) 
                                                                                       8.                **MAXIMUM AMOUNT ALLOWED IS $200**                $
    C.SALES SHIPPED OUT OF THE  OWNT OF  ASTLE C OCKR                          $
                                                                                                 TOTAL SALES TAX DUE   (LINE 7MINUS LINE 8)                $
    D.BAD DEBTS CHARGED OFF    ON( WHICH TOWN TAX WAS PREVIOUSLY PAID    )     $       9.
                                                                                                                   PENALTY:  GREATER OF $10                 PUT TOTAL 
    E.TRADE INS- FOR TAXABLE RESALE                                            $                 LATE FEES DUE             OR15%OF LINE9         $$         BELOW
                                                                                       10.       IF FILED AFTER          INTEREST: 1.5% PER 
    F.SALES OF GASOLINE AND CIGARETTES                                         $                 DUE DATE                  MONTH OF LINE9                  $
    G.SALES TO GOVERNMENTAL RELIGIOUS,   AND, CHARITABLE ORGANIZATIONS         $       11.       PRIOR PERIOD ADJUSTMENT FOR OVER OR UNDERPAYMENTS         $
                                                                                                      TOTAL DUE AND PAYABLE  ADD–   LINES  THROUGH9   11 
    H.RETURNED GOODS    ON( WHICH TOWN TAX WAS PREVIOUSLY PAID     )           $       12.             (MAKE CHECK PAYABLE TO  OWN T  F OASTLE C OCKR )    $
    I.PRESCRIPTION DRUGS PROSTHETIC/ DEVICES                                   $       MY SIGNATURE AFFIRMS THAT IHAVE READ THIS RETURN AND IT IS TRUE AND CORRECT TO                  
                                                                                       THE BEST OF MY KNOWLEDGE AND IS SIGNED SUBJECT TO PENALTIES FOR PERJURY AND 
    J.FOOD PURCHASED WITH FOOD STAMPS WIC/    VOUCHERS                         $       OTHER CRIMINAL OFFENSES     . 
    K.OTHER DEDUCTIONS    PLEASE( EXPLAIN)                                     $       SIGNATURE:  
3.                                 TOTAL DEDUCTIONS   (ADD LINES 3A THRU 3K)   $       DATE:                                     TITLE:  
4.           TOTAL TOWN NET TAXABLE SALES &SERVICE   LINE(    2BMINUS LINE 3)  $       PHONE:                                    EMAIL:  

                                                      CONSOLIDATED ACCOUNTS REPORT 
    This schedule is required in all cases where the vendor is reporting sales for more than one location within the Town of Castle Rock.  Each location must have a separate license.
Account Number        Business Location Address                                Total Gross Sales              Total Deductions                      Net Taxable Sales 
                                                                           $                           $                                      $ 
                                                                           $                           $                                      $ 
                                                                           $                           $                                      $ 
                                                               Totals:     $                           $                                      $ 

                                                                               CHANGES 

Mailing Address 
Address:                                                           New Email:                                              New Owners (Requires a new license) 
                                                                                                                            Date:    
City, ST, Zip:                                                     New Business Phone:                                      Name:  
                                                                                                                            Phone: 
Business Location Address                                          New Contact Phone: 
Address:                                                                                                                   Business Closure or Sale (see instructions) 
                                                                   Filing Frequency:  Call or email for change              Date:  
City, ST, Zip:  

                                                SALES TAX RETURN INSTRUCTIONS 

            If you deliver   or ship product     out   of the  Town   of Castle    Rock     and   you     are unsure   of the   “in/out”    status   of the address,   please 
Line 3C    
            email, call,   or fax our division   for verification.    An address locator   is available   on our            website   and   by request   from      our division. 

            Sales   to exempt     organizations      must   be supported     by a “State   of Colorado”             exemption    certificate.  Place  the exempt       number    of 
Line 3G    
            the organization   on your     invoice.  The number must begin with “98”                      (i.e., 98-xxxxx-xxxx). 

            Only food purchased       with food stamps,   or WIC            vouchers      may   be deducted.  The Town   of Castle Rock’s            tax rate   on “Food    for 
            Home Consumption”   is 4.0%.  Do            not deduct food sold       unless stamps   or vouchers             are collected   from the   customer.  Food and 
Line 3K    
            drink sold “ready   to eat”,   or food      sold   as “immediate         consumption”,         are taxed     at the full applicable rate,   including    the State   of 
            Colorado tax.  (See State FYI Sales   4)

Line 5a     Enter the amount of sales subject to lodging tax times the lodging tax rate of 6.0%.  Lodging tax is in addition to the sales tax 
            due on these sales.

Line 5b     Lodging tax will be calculated at 6.0% of the amount of sales entered subject to lodging tax. (Line 5a x 6.0%)

            If sales taxes   collected,    during    the  reporting     period,  exceed   the    amount       calculated   on Line   4, you must   report and      remit the 
Line 6  
            excess   on this  line. 

            This amount reimburses         the   vendor   for collecting     our sales    tax.      It is not   an additional cost   to the vendor.  Do not add this 
Line 8  
            calculation   to the tax.  The amount you keep   is limited   to $200 per return.  NOT APPLICABLE ON                            LATE   RETURNS.           

            Returns    are due   on the 20thday      of   the month     following the     reporting period.      For  example    on     a monthly return: The      due date 
            for the period   of May   1stthrough     May      31 isst  June 20 . Forth    example on a     quarterly return:   The  due date   for the   period     of  
Line 10     April 1stthrough  June    30  isth  July 20 . Returnsth     are considered    late   if the   payment   or   return is not   received,   or     if the envelope 
            is not postmarked   by the     USPS,     on or before       the  due date. 

            Penalty calculation:          Late returns        will   be assessed   a penalty equal   to the        sum   of $10,   or fifteen percent   (15%),     whichever is 
                                          greater. 
                                                                 Tax Due                             Penalty 
                                                                 $0.00 through $67.00                $10.00 
                                                                 $67.01 and   up                          Tax Due   x 15% 

            Interest calculation:         Late returns        are assessed     interest   equal   to 1.5%     per   month   from  the   due date   of the payment.     For 
                                          example,    interest     on a late   return   for the  period   of May      1stthrough   May 31stis  calculated   as   followed:    

                                          Date Filed               Number of Months Late                           Interest Due 
                                          June 20th                               0                                 None 
                                          June 25th                               1                                Tax Due   x 1.5%     x 1
                                          July 23rd                                2                               Tax Due   x 1.5%     x 2
                                          August     19th                          2                                Tax Due   x 1.5%     x 2
                                          August     21st                          3                                Tax  Due   x 1.5%   x 3 

Line 11     If you received   a credit notice,      please    deduct    the  credit  amount      here. 
            If you receive   a notice   of assessment   for underpaid            tax,     please add      the total amount   of the   assessment     due  here. 

            If your business has      been      sold     to a new owner,    sales tax     may   be due   on the     selling price   of the tangible  personal      property 
Sale   of a assets, except   for inventory     to be resold.  Report the taxable sales amount and                     tax  due     on a separate tax  return   noting  that 
Business    the return     is for the sale   of the business.  See State Code Section 39-26-102(10)         for a list of types   of business               sales    that are 
            not subject   to sales    tax.