City of Northglenn 
               11701 Community Center Drive 
               Northglenn, CO  80233-8061 
               P:  303.450.8729 
               F:  303.450.8708 
               salestax@northglenn.org   
                                                                        
                     Initial Use Tax Return 
 
This form is to be used by new businesses or organizations located in the City of Northglenn to report initial use tax.  
Since use tax applies to all businesses and organizations, please make sure to understand the use tax explained in 
the Sales and Use Tax Information Brochure.  If no use tax is due, this return must still be filed.  If the initial use tax 
was reported on a regular sales/use tax already filed, please file this return with a note stating this fact.  Please fill 
out all applicable sections of this return.  Please report all subsequent taxable purchases on the regular sales/use 
tax returns. 

 Business Name       

 Business Address   

 Account Number                                    Payment Due Date      
 
                     Section A:  Startup of a New Business 
 
Itemize all purchases made incidental to the startup of the business for furniture, fixtures, and/or supplies (not 
inventory) that were purchased from a vendor that did not charge a City sales tax on the item (many vendors 
charge State tax but not City tax).  If a vendor charged less than 4% city sales tax, the difference of the tax rates 
must be multiplied by the taxable amount and reported on the “Excess Tax Due” space below. 
 
 Invoice Date     Vendor’s Name & Address         Taxable Amount        4% Tax Due         Excess Tax 
                                                                                           Due 
                                                                                            
                                             Section A Totals 
                                                                                            
                                            (OVER) 
                                              

                   Section B:  Purchase of an Existing Northglenn Business 
 
New owners of an existing Northglenn business must pay the 4% use tax on all furniture, fixtures, supplies (not 
inventory), and leasehold improvements listed on the purchase contract. 
 
 Purchase               Seller’s Name & Address            Purchase Price of Items          4% Tax Due 
 Date 

                  Section C:  Leases of Equipment, Fixtures, and/or Furniture 
 
Please list your leases.  Indicate whether the City tax is paid by the lessor or the lessee.  If the lessor does not 
charge City sales tax, the lessee is responsible for paying City use tax for all lease payments going forward on the 
regular sales/use tax returns. 
 
                                                                   Lease Payment           4% Tax Due From 
 Lessor Name                     Lessor Address 
                                                                         Amount       Lessor    Lessee 

                                                  Section C Totals                                                    

  Total amount of lease payments to date where lessor did not charge City sales tax:         

                                                                         4% Tax Due:         
 
                                   Section D:  Total Due 
 
               Line 1:  Total Taxable Amount from Sections A, B, and C     

               Line 2:  Total Tax Due from Sections A, B, and C            

               Line 3:  Penalty (If filed after due date) (Line 2 x 15%)   

                        Interest (Line 2 x 0.5% x number of months late) 
               Line 4: 
                        (If filed after due date)                          

               Line 5:  Total Due (Add Lines 2, 3, and 4)                  
 
I hereby certify under penalty of perjury, that the statements made herein are to the best of my knowledge, true, and correct. 
 
Signature:                                                         Date:                                                        
 
Printed Name:                                                            Phone Number: