Denver Sales Tax Return                                                           Department of Finance,City and CountyTreasuryofDivisionDenver
                                                                                                 Monthly 
                                                                                                                                                              P.O. Box 660860 
                                                                                                                                                Dallas, TX  75266-0860 
                                                                                                                                         www.DenverGov.org/eBizTax 

Business Name                         Account Number                          Phone Number 
                                                                                                              u   YOU MUST FILE A RETURN EVEN IF YOU
                                                                                                                  HAVE DETERMINED THAT NO TAX IS DUE 
Primary Business Location                                                     Period End Date                     IMPORTANT INFORMATION IS ON THE BACK
                                                                                                              u

                                                                                                              u   INSTRUCTIONS ARE ON THE BACK
SCHEDULE A - SALES TAX                 CHECK HERE IF THIS IS AN AMENDED RETURN
1  Gross Sales and Services           (Total receipts from City activity must                    ACCOUNT NUMBER           PHONE NUMBER          PERIOD END 
   be reported and accounted for in every return including sales, rentals,    00 
   leases, online sales and all services both taxable and non-taxable)                        DUE DATE                   TAX TYPE               MEDIA # 
2  A. Add: Bad debts collected that were previously deducted in prior         00              20-Dec-9999                Sales Tax              0000000000064268195847
      periods 
   B. Enter the Total of Lines 1 & 2A                                         00                                  SCHEDULE B - USE TAX 
3  Deductions included in line 1 above 
                                                                                                   Gallons of 
   A. Non-Taxable services or labor                                           00                 1 Aviation / Railway                 x 4¢ /gal                               00
   B. Sales to other licensed dealers for the purpose of taxable resale       00                   Fuel Purchased

   C. Sales of goods shipped or delivered outside City and/or State           00               2   Short-Term                      00 x 7.25%                                 00 
                                                                                                   Vehicle Rental 
   D. Bad debts (open accounts sales on which DENVER tax was                  00 
      previously paid) 
   E. Trade-ins for taxable resale                                            00                 3 Taxable Food &                  00 x 4.00%                                 00 
                                                                                                   Beverage 
   F. Sales of gasoline and cigarettes                                        00 
   G. Exempt sales to governmental and charitable organizations               00                 4 Other Taxable                   00 x  4.81%                                00 
                                                                                                   Purchases 
   H. Returned goods (on which DENVER tax was previously paid)                00 
   I. Sales of exempt prescription drugs                                      00                   Add Incremental Tax Due (See instructions on the                           00 
                                                                                                 5 
   J. Sales of exempt groceries                                               00                   back) 
   K. Sales of Aviation / Railway Fuel (Put gallons sold on Line 5A below)    00 
   L. Other deductions                                                        00                 6 Consumer Use Tax (Total of Lines 1-5)                                      00

   M. Total deductions (Total of Lines 3A thru 3L)                            00                         Line 6 must be included on line 8 of Schedule A 
4  Net Taxable Sales & Services (Line 2B minus Line 3M)                       00 
5  A. Gallons of Aviation /                                x 4¢ / gal         00 
      Railway Fuel Sold                                                                                                   ADDRESS CHANGE 
   B. Receipts from Short-Term                          00      x 7.25%       00                   MAILING ADDRESS             LOCATION ADDRESS               BOTH
      Vehicle Rentals 
   C. Sales of Retail                                   00 x 10.31%           00                 STREET: 
      Marijuana 
   D. Sales of Taxable Food and                         00      x 4.00%       00 
      Beverages 
   E. Other Taxable Sales 
      (Line 4 less Lines 5B, 5C & 5D)                   00      x  4.81%      00                 CITY: 
   F. Total of Lines 5A thru 5E                                               00                 STATE:                               ZIP CODE: 
6  Add excess tax collected from customers                                    00                 PHONE: 
7  Subtotal of tax (Add Lines 5F and Line 6)                                  00 
                                                                                                 FAX: 
8  Consumer Use Tax (Line 6 from Schedule B)                                  00 
                                                                                                 EMAIL: 
9  Tax Due (Add Lines 7 and 8)                                                00 
10 Late Filing - if   A.  Penalty: The greater of 15% of line 9 or $25.00     00                   Please check this box if these changes also need to be applied to 
   return is filed                                                                                 your Occupational Privilege Tax account 
   after due date -   B.  Interest: 1% of line 9 for each month that the      00 
   Add:                 return is late                                                           If the status of your business has changed, please complete the Account 
   TOTAL DUE AND PAYABLE                                                                               Change or Closure Request Form located at our website: 
11                           (Add lines 9, 10A & 10B):                        00                                         www.denvergov.org/treasury 
   Include a check or money order  made payable to: MANAGER OF FINANCE 

                                                                                                                          0000000000064268195847
I hereby certify, under penalty of perjury, that statements made herein are to the best of my knowledge true and correct.
 Signature (Required)                                                         Title                                                      Date

u Important Information: The City and County of Denver is now offering online filing for Sales, Use, Lodger's,
   Occupational Privilege, Facilities Development Admissions, Telecommunications Business Tax, and Emergency
   Telephone Charges (E911). For more information or to register online, visit www.DenverGov.org/eBizTax.

All entries on this sales tax return must be rounded to the nearest dollar. You will still collect and keep track of exact amounts of 
sales tax. Books, records, and statements or invoices to buyers must reflect actual tax amounts. It is only when you fill out the 
return that you will round the numbers you are reporting. Round amounts under 50 cents down to 0 (zero) cents. Increase amounts 
from 50 to 99 cents to the next dollar. 
   If you need further assistance or have any questions on how to fill out this return, please contact the City of Denver Taxpayer Service at (720) 913-9400 or please visit our  
                                                                   website at www.denvergov.org/treasury. 
                                                           INSTRUCTIONS - SCHEDULE A - SALES TAX 
   Sales tax is imposed on the purchase price paid or charged on retail sales of tangible personal property, products, and certain services. Taxable services include, but are 
not limited to, the sale or furnishing of telephone and certain telecommunications services, electricity, steam and natural gas for energy producing purposes, informational, 
                         and entertainment services.  Sales tax returns and payment are due on the 20th of the month following the taxable period. 

          non-taxable. Please be sure to include any online sales. 
Line   1  Enter total receipts from all sales and services both taxable and            LineLine3M4  EnterEnterthethetotaldifferenceof Linesbetween3A thru 3L.Lines 2B and 3M.     
Line 2A  Enter bad debts collected during the period which were previously             Line 5A      Enter the number of gallons for Aviation and Railway fuel sold and multiply 
          deducted on Line 3D in prior periods.                                                     by 4 (four) cents per gallon. 
Line 2B  Enter the total of Lines 1 and 2A.                                            Line 5B      Enter receipts from short term (30 days or less) automotive vehicle rentals 
Line 3A  Enter receipts from non-taxable services or labor.                                         and multiply by 7.25%. 
Line 3B  Enter sales to other licensed dealers for resale.                             Line 5C      Enter receipts from sale of retail marijuana and multiply by 10 3. 1%. 
Line 3C Enter sales of goods shipped or delivered outside of Denver to a                            NOTE: This tax rate includes the standard 4.81% sales tax rate, plus the special 5.5% tax 
          non-resident. Note: Delivery must have been made by company vehicle,                      rate for retail marijuana. Sec 53-92
          common carrier, or by mail.                                                  Line 5D      Enter receipts from sale of taxable food and beverages at Sec. 5 -3 54 5( ) 
Line 3D Enter unsecured bad debts from open accounts written off during the                         and multiply by 4.0%. 
          period. Enter only those bad debts upon which Denver tax was                 Line 5E      Subtract Lines 5B, 5C & 5D from Line 4, enter the difference, and multiply
          previously remitted. Note: Bad debts are not deductible if returns are filed              by 4.31%. 
                                                                                       Line 5F 
          on a cash basis, or, if the seller retains title to the merchandise as                    Enter the total sales tax computed on Lines 5A thru 5E.
          collateral.                                                                  Line 6       Enter the amount, if any, of Denver tax collected from customers in excess 
Line 3E  Enter the amount allowed customers for trade-ins during the period.                        of the amount on Line 5F. 
          Note: This deduction is allowed only if the exchanged property will be       Line 7       Enter the totals of Lines 5F and 6. 
          resold at retail by the taxpayer.                                            Line 8       Enter the total consumer use tax from Line 6 Schedule B-City Use Tax.  
                                                                                       Line 9       Enter the total of Lines 7 and 8. 
Line 3F  Enter receipts from sales of gasoline and cigarettes. 
Line 3G Enter receipts from sales to charitable or governmental organizations          Line 10A  If your return is filed after the due date, enter 15% of Line 9, or $25.00, 
          which are exempt from Denver tax.                                                         whichever is greater. Note: Any return not received by the due date will be 
                                                                                                    considered late. 
Line 3H Enter the sales amount of any goods returned during the period on which        Line 10B  If your return is filed after the due date, enter 1% of Line 9 for every 
          Denver tax was previously remitted.                                                       month past due. Interest accrues at 1% of the tax amount beginning on 
Line 3I  Enter receipts from sales of prescription medicines.                                       the 1st day after the due date and adds an additional 1% on the 21st day 
Line 3J  Enter receipts from sales of exempt grocery foods.                                         of each subsequent month. 
Line 3K  Denver sales tax is due on the amount of GALLONS of Aviation/Railway          Line 11  Enter the totals of Lines 9, 10A and 10B. Include                                 with your return a check 
          fuel sold, not the dollar amount.  Enter the portion of Line 1 that                       or money order payable to the Manager of Finance. 
          represents the gross sales amount of Aviation/Railway fuel on Line 3K. 
          Then enter the gallons of Aviation/Railway fuel sold on line 5A. 
Line 3L  Enter other deductions 
                                                           INSTRUCTIONS - SCHEDULE B - CITY USE TAX 
   Consumer Use Tax is imposed upon the privilege of using, storing, distributing or otherwise consuming purchased, rented or leased, unless specifically exempt, when Denver’s 
   sales tax has not been paid on that purchase.  If goods have been purchased tax free, such as supplies, fixtures, furniture, equipment, etc., for personal or business use or 
                        consumption, the applicable tax is due thereon. This would also include any goods drawn from inventory for personal or business use. 
   Line 1  Enter the number of gallons for Aviation and Railway fuel purchased and     Line 5  Enter any incremental tax due.  If tax was properly paid to another jurisdiction 
          multiply by 4 (four) cents per gallon.                                                 at a tax rate less than Denver’s combined rate (                            8. 18 % non-food, 8.0% food), 
Line 2  Enter the total purchases of short-term (30 days or less) automotive                     incremental tax is due for the difference between the tax charged and Denver’s 
          vehicle rentals and multiply by 7.25%                                                  combined rate.  No credit is given for tax rates in excess of the Denver 
Line 3  Enter the total of purchases of taxable food and beverage and multiply by                combined rate.  See Tax Guide topic “Reduction Allowed for Previously Paid 
          4.0%                                                                                   Sales or Use Taxes” for more detailed information. 
Line 4  Enter the total of all other purchases and multiply by  4.81%                  Line 6  Total lines 1 through 5, this is the use tax due.  Enter this amount on Line 8 of 
                                                                                                 Schedule A 
                                                                INSTRUCTIONS - ADDRESS CHANGE 
                                              Please fill out the Address Change section if your business address or location has changed. 
          If the status of your business has changed, please complete the Account Change or Closure Request Form located at our website:  www.denvergov.org/treasury 
                                                                   YOU MUST SIGN YOUR RETURN