Form USU−103
State form 52709
(R14 / 7-19)
Indiana Department of Revenue
Utility Services Use Tax
Report address changes on the USUT Change Form.
For assistance, call (317) 232−0129 or visit
Taxpayer ID Number:
Filing Status:
Corresp ID:
This packet contains monthly return(s) for reporting Utility Services Use Tax (USUT). For an explanation of Utility Services Use Tax, see
Commissioner’s Directive 32 at A Change Form to report any changes in your address is included. Your
USUT returns are due on the date printed on your return. Make sure the information on this page is correct and complete.
Payments must be made with U.S. funds.
Please do not include check stubs when
mailing your payments.
When a business location is closed, please complete Form BC−100 and attach the appropriate documentation. Request form BC−100 by
calling (317) 615−2581 or visiting
Do not make corrections on the preprinted USU−103 return; please use the USUT Change Form. Do not print name or address
changes or corrections on the individual return.
If the taxpayer identification number listed on your return is not correct, contact the department by visiting
or calling (317) 232−0129.
A return must be filed by the taxpayer even when no tax is due unless the business has been closed. If no return is filed,
an estimated return will be filed by the department based on the best information available (IC 6−8.1−10−3).
Due Date Notice
The due date is the thirtieth day after the end of the month in which the utility services were purchased. If the due date falls on a
weekend or legal holiday, the payment and return are due on the next business day.
U.S. Postal Service postmark date determines if a return is filed timely. Please be aware of your local postal service’s hours of mail
pickup. A payment made (postmarked or initiated by electronic funds transfer) after the due date of the return is subject to a penalty of
10 percent of the amount due or $5, whichever is greater, plus interest.
Do not send the Change Form with return. Use a separate envelope. Mail
to the Indiana Department of Revenue, P.O. Box 6197,
Indianapolis, IN 46206−6197. This will only change the address(es) for your Utility Services Use Tax Account. Do not use this
form to close your business; you must complete and submit Form BC−100.
DBA Name
Contact Name
Taxpayer ID Number:
Update Location Address
Signature Title Date
USUT Change Form
ZIP Code
Federal ID # County
Phone #
DBA Name
Contact Name
ZIP Code
Federal ID # County
Phone #
Update Mailing Address for Returns
Due on or Before
Taxpayer ID Number For Tax Period
Date Phone ______________________
P.O. Box 7206
I declare under penalties of perjury that this is a true, correct and complete return.
Filing Status
USU−103 0812
Total gross sales to Indiana consumers by utility
service providers collecting USUT.....................
Total amount due (Add Lines 5 through 8)......
Late payment penalty: If late, penalty is the
greater of $5 or 10% of Line 5.......................
Amount of consumer purchases from utility
service providers not collecting USUT..............
Adjustments − Attach proof for deductions.......
Total: Amount from Line 1 or 2 less Line 3....
USU Tax due: Line 4 amount X 0.014 (1.4%)
Interest due: If late compute annual interest on
amount from Line 5.........................................
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Instructions for Completing Form USU−103
(The following instructions are valid for this form only.)
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Remember to keep records of each USUT payment. Keeping an accurate record of your estimated tax payments will help resolve any delays in the processing
of your return. If your carryover credit has been adjusted, please revise your records so you may claim the proper amount on your next year’s annual tax return.
You must file a monthly return even if no tax is owed.
Make sure all preprinted information is correct for the tax period you are filing. Please sign and date each return.
1. Total gross sales to Indiana consumers by utility service providers collecting USUT − Enter the amount of gross receipts received for furnishing utility services on
which Utility Services Use Tax was collected on behalf of your Indiana customers for the retail consumption of utility services in Indiana during the period. The collection
of any general sales tax, Indiana utility receipts tax, or use tax paid to another state should not be included. Complete this line only if you are a utility service provider.
2. Amount of consumer purchases from utility service providers not collecting USUT − Enter the gross amount of all utility services purchased for retail. Complete
this line only if you are remitting as an Indiana consumer of utility services.
3. Adjustments − Enter the portion of receipts or amounts included on Line 1 or 2 on which USUT was paid on purchases from service providers or was otherwise exempt
from USUT. Documentation of any adjustment must be submitted with the return.
4. Total − Enter the amount from Line 1 or 2, minus the amount (if any) on Line 3.
5. Utility Services Use Tax due for the period − Multiply Line 4 by the tax rate of 1.4 percent (0.014).
6. Interest due − A payment made after the due date is subject to interest. Interest is computed from the tax due date to the date payment is postmarked. To calculate
interest, multiply the amount due by the annual interest rate and divide the result by 365. Multiply that result by the number of days the payment is late. Do not compute
interest on any late payment penalty entered on Line 7.
7. Late payment penalty − Payments postmarked after the due date are also subject to a 10 percent penalty. The penalty must be computed by multiplying 10 percent
(0.10) by the amount on Line 5 or $5, whichever is greater. Do not compute penalty on the interest amount due entered on Line 6.
8. Total amount due − Add Lines 5 through 8. This is the amount you owe. Make check or money order payable (in U.S. funds) to the Indiana Department of Revenue. If
the result is a negative figure, carry the net overpayment to the next month.
Please do not send cash. Make check payable (in U.S. funds) to the Indiana Department of Revenue.
For assistance, call the corporate tax information line at (317) 232−0129 or visit