Fillable FORM G-49: GE GENERAL EXCISE/USE ANNUAL RETURN & (Hawaii)

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FORM G-49: GE GENERAL EXCISE/USE ANNUAL RETURN & (Hawaii)

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Column a Column b Column c
BUSINESS VALUES, GROSS PROCEEDS EXEMPTIONS/DEDUCTIONS TAXABLE INCOME
ACTIVITIES OR GROSS INCOME (Attach Schedule GE) (Column a minus Column b)
PART I - GENERAL EXCISE and USE TAXES @ ½ OF 1% (.005)
1. Wholesaling 1
2. Manufacturing
2
3. Producing
3
4. Wholesale Services
4
5
6
7. Sum of Part I, Column c (Taxable Income) — Enter the result here and on page 2, line 21, Column (a)
7
PART II - GENERAL EXCISE and USE TAXES @ 4% (.04)
8. Retailing
8
9
10. Contracting
10
11
12. Commissions
12
13
14. Other Rentals
14
15
16
17. Sum of Part II, Column c (Taxable Income) — Enter the result here and on page 2, line 22, Column (a)
17
5. Landed Value of
Imports for Resale
6. Business Activities of
Disabled Persons
9. Services Including
Professional
11. Theater, Amusement
and Broadcasting
13. Transient
Accommodations Rentals
15. Interest and
All Others
16. Landed Value of Imports
for Consumption
DECLARATION - I declare, under the penalties set forth in section 231-36, HRS, that this return (including any accompanying schedules or statements) has been
examined by me and, to the best of my knowledge and belief, is a true, correct, and complete return, made in good faith for the tax period stated, pursuant to the
General Excise and Use Tax Laws, and the rules issued thereunder.
IN THE CASE OF A CORPORATION OR PARTNERSHIP, THIS RETURN MUST BE SIGNED BY AN OFFICER, PARTNER OR MEMBER, OR DULY AUTHORIZED AGENT.
SIGNATURE TITLE DATE DAYTIME PHONE NUMBER
Continued on page 2 — Parts V & VI MUST be completed
Form G-49
(Rev. 2017) 16
DO NOT WRITE IN THIS AREA
16
FORM G-49
(Rev. 2017)
TAX YEAR ENDING
HAWAII TAX I.D. NO.
GE
Last 4 digits of your FEIN or SSN
NAME:
Place an X in this box ONLY if this is an AMENDED return
STATE OF HAWAII — DEPARTMENT OF TAXATION
GENERAL EXCISE/USE
ANNUAL RETURN &
RECONCILIATION
• ATTACH CHECK OR MONEY ORDER HERE •
G49_F 2017A 01
PRINT FORM
RESET FORM
HELP
ID NO 99
t
If negative number, place a minus sign (-)
t
If negative number, place a minus sign (-)
Note: Due date is the 20th day of the 4th month following the close of your tax year
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Thank you.
FORM G-49
Page 2 of 2
Column a Column b Column c
BUSINESS VALUES, GROSS PROCEEDS EXEMPTIONS/DEDUCTIONS TAXABLE INCOME
ACTIVITIES OR GROSS INCOME (Attach Schedule GE) (Column a minus Column b)
PART III - INSURANCE COMMISSIONS @ .15% (.0015)
18
Enter this amount on line 23, Column (a)
PART IV - CITY & COUNTY OF HONOLULU SURCHARGE TAX @ ½ OF 1% (.005)
19. Oahu Surcharge
19
Enter this amount on line 24, Column (a)
18. Insurance
Commissions
PART VI - TOTAL RETURN AND RECONCILIATION
TAXABLE INCOME TAX RATE TOTAL TAX
Column (a) Column (b) Column (c) = Column (a) X Column (b)
21. Enter the amount from Part I, line 7 ................... x .005 21.
22. Enter the amount from Part II, line 17 ................ x .04 22.
23. Enter the amount from Part III line 18, Column c ............. x .0015 23.
24. Enter the amount from Part IV, line 19, Column c ............ x .005 24.
25. TOTAL TAXES DUE. Add column (c) of lines 21 through 24 and enter result here. If you
did not have any activity for the period, enter “0.00” here .........................................................25.
26. Amounts Assessed on Periodic Returns...................
PENALTY $
INTEREST $
26.
27. TOTAL AMOUNT. Add lines 25 and 26. ...................................................................................27.
28. TOTAL PAYMENTS MADE LESS ANY REFUNDS RECEIVED FOR THE TAX YEAR ................... 28.
29. CREDIT CLAIMED ON ORIGINAL ANNUAL RETURN. (For Amended Return ONLY) ................... 29.
30. NET PAYMENTS MADE. Line 28 minus line 29 ..............................................................................30.
31. CREDIT TO BE REFUNDED. Line 30 minus line 27 ....................................................................... 31.
32. ADDITIONAL TAXES DUE. Line 27 minus line 30 ..........................................................................32.
33. FOR LATE FILING ONLY
PENALTY $
INTEREST $
33.
34. TOTAL AMOUNT DUE AND PAYABLE (Add lines 32 and 33) ........................................................34.
35. PLEASE ENTER THE AMOUNT OF YOUR PAYMENT. Attach a check or money order payable
to “HAWAII STATE TAX COLLECTOR” in U.S. dollars to Form G-49. Write the filing period and your Hawaii Tax
I.D. No. on your check or money order. Mail to: HAWAII DEPARTMENT OF TAXATION, P. O. BOX 1425,
HONOLULU, HI 96806-1425 or file and pay electronically at hitax.hawaii.gov.
If you are NOT submitting a payment with this return, please enter “0.00” here. ...................35.
36. GRAND TOTAL OF EXEMPTIONS/DEDUCTIONS CLAIMED.
(Attach Schedule GE) If Schedule GE is not attached, exemptions/deductions
claimed will be disallowed. ..........................................................................................36.
PART V — SCHEDULE OF ASSIGNMENT OF TAXES BY DISTRICT (ALL taxpayers MUST complete this Part and may be subject to a
10% penalty for noncompliance.) See Instructions. Place an X in the box of the taxation district in which you have conducted business. IF you did business
in MORE THAN ONE district, place an X in the box for “MULTI” and attach Form G-75.
20. Oahu Maui Hawaii Kauai MULTI
20
Form G-49
(Rev. 2017) 16
Name:
Hawaii Tax I.D. No.
GE
Last 4 digits of your FEIN or SSN
TAX YEAR ENDING
G49_F 2017A 02
t
If negative number, place a minus sign (-)
t
If negative number, place a minus sign (-)
t
If negative number, place a minus sign (-)
To enter a value in line 29 mark the "Amended" checkbox on page 1
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FORM G-49: GE GENERAL EXCISEUSE ANNUAL RETURN & (Hawaii)

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Completed 28 January 2022

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