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Completing Form URT-Q(w) for Quarterly Payments
Compute 25% of the annual estimated utility receipts tax or
the exact amount of tax for the quarter. You may reduce the
quarterly estimated payment by the amount of your over-
payment of tax from a prior year that was applied to your
estimated account. Enter the net amount on the appropriate
remittance form. An authorized ocer must sign and date
each remittance form. Mail payment by your quarterly re-
turn due date. The utility receipts tax rate is 1.4%, eective
Jan. 1, 2003.
The quarterly estimated utility receipts tax return with pay-
ment is due on the 20th day of the 4th, 6th, 9th, and 12th
months of the taxable year (regardless of whether you’re
ling on a calendar-year or scal-year basis).
Indiana Department of Revenue
Indiana Utility Receipts Tax Returns
This form should be used for remitting the required quarterly estimated tax payments for the current calendar year (or
taxable scal year) or for remitting your extension payment. Do not use Form URT-Q(w) to remit any other income tax
payments. The annual Utility Receipts Tax Return, Form URT, is available as a separate form.
If a taxpayer’s annual tax liability exceeds $2,500, the taxpayer is required to le quarterly estimated payments and remit
25% of the estimated annual tax due on each quarterly return. Assistance and preprinted quarterly payment coupons may
be obtained by calling the Corporate Tax Section at 317-232-0129.
If a taxpayer’s estimated quarterly utility receipts tax liability exceeds $5,000, the taxpayer shall pay the estimated
utility receipts tax due by electronic funds transfer (EFT) or by delivering in person or by overnight courier a payment by
cashier’s check, certied check, or money order to the department. The transfer or payment shall be made on or before
the date that the tax is due. If the taxpayer’s utility receipts tax payment is made by EFT, the taxpayer is not required
to le an estimated utility receipts tax return. Questions concerning EFT can be directed to departmental personnel by
calling (317) 232-5500.
Instructions
Completing Form URT-Q(w) for an Extension Payment
This web version of Form URT-Q can be used to make an
extension payment. It is to be used when a payment is due
and additional time is necessary for ling the annual utility
receipts tax return. A penalty for late payment will not be
imposed if at least 90% of the annual tax due is paid by the
original due date and the remaining balance, plus interest,
is paid in full by the extended due date. Also, a copy of the
federal extension of time to le form must be enclosed with
the annual return when led.
The extension payment is due on the 15th day of the 4th
month following the close of the tax year.
The U.S. Postal Service postmark date is used to deter-
mine if a return is timely. Please be aware of the local
postal service’s hours of mail pickup.
Payments must be made with U.S. funds.
Please do not send cash or include check stubs
when mailing your payments.
Online Resources
Refer to Commissioner’s Directive #18 at
www.in.gov/dor/reference/les/cd18.pdf for more informa-
tion. An annual URT reporting form with instructions is
available at www.in.gov/dor/3501.htm.
Taxpayer Name
Street Address
City State ZIP Code
Voucher - Check box to show which payment you are making:
□ 1st Quarter □ 2nd Quarter □ 3rd Quarter □ 4th Quarter
□ Extension Payment
Calendar or Fiscal Year Ending __________ Due Date __________
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7228
INDIANAPOLIS, IN 46207-7228
Utility Receipts Tax Payment
Form URT-Q(w)
State Form 52225 (R5 /8-19)
Federal Employer Identication Number
_________________________________________________
Signature of Ocer Title
Date __________ Daytime Phone # ____________________
Make check payable to the Indiana Department of Revenue.
Estimated Utility Receipts Tax Due.
