= Tax Amount
Delinquent If Not Received By
SUBTOTALS
Check here if mailing
address has changed.
Please make corrections to
the preprinted address.
License Number
TRANSACTION PRIVILEGE (SALES) AND USE TAX RETURN
Period Ending
Location Address:
Under penalties of perjury, I declare that I have examined this return, including the accompanying schedules and statements, and to the best of my knowledge and belief it is true,
correct and complete. The declaration of the paid preparer is based upon all information of which the preparer has any knowledge.
A SIGNATURE IS REQUIRED TO MAKE THIS RETURN VALID
Return original with remittance in envelope provided.
Please make check payable to: CITY OF CHANDLER and list your license number on your check.
Complete Both Sides of Form
From Sch. A, on back
- Deductions
= Net Taxable
Column 1 Column 2 Column 3 Column 5
x Tax
Rate
Gross Receipts / Use Taxable Purchases
, , .
Col. 4
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Business Activity
Business
Class
Code
99
ENTER EXCESS CITY TAX COLLECTED (From SCHEDULE C on the back)
TOTAL TAX DUE (Add lines 6 plus 7)
PENALTY & INTEREST (See instructions on back)
ENTER TOTAL LIABILITY (Add lines 8 plus 9)
ENTER CREDIT BALANCE TO BE APPLIED (From Schedule B, on back)
ENTER NET AMOUNT DUE (Subtract line 11 from line 10)
ENTER TOTAL AMOUNT PAID
THIS RETURN IS DUE ON
THE 20TH OF THE MONTH
Line
USE TAX
1
2
3
4
5
6
Taxpayer's Signature Paid Preparer's Signature
Printed Name Printed Paid Preparer's Name
1.5%
Plus (+)
Equals (=)
Plus (+)
Equals (=)
Minus (-)
Equals (=)
7
8
9
10
11
12
13
Date
Phone Number
Mail Stop 701
PO Box 15001
Chandler, AZ 85244-5001
City of Chandler
TOTAL FROM ADD'L PAGES
Place a check here and sign at the
bottom if you have no activity to report.
4615125699
0.00
0.00
0.00
0.00
.015
82
DUE DATE
: City privilege tax returns are due on the 20th of the month following the reporting period. A return must be submitted even if no taxes are due. A return is considered
delinquent if not
received
by the last business day of the month. A business day is any day except Saturday, Sunday or a legal City holiday.
Postmarks are not evidence of timely filing.
PENALTIES:
1. Failure to File - A penalty of 5% of the tax due will be assessed for each month, or fraction thereof, elapsing between the delinquency date of the return and the date received.
2. Failure to Pay - A penalty of 10% of any unpaid tax will be assessed if the tax due is not paid on or before the delinquency date.
3. Total Penalty - Combined Failure to File and Failure to Pay penalties assessed will not exceed 25%.
INTEREST:
Taxes unpaid after the delinquency date are assessed interest that cannot be waived. Beginning 10/01/05, the interest rate is the rate in effect for the Arizona Depart-
ment of Revenue, and outstanding interest is compounded annually on January 1.
SCHEDULE A - DETAILS OF DEDUCTIONS:
All deductions and exemptions used in computing City transaction privilege tax must be entered below. Detailed records supporting all
deductions and exemptions claimed must be maintained. Failure to maintain supporting records may result in the disallowance of claimed amounts.
Please note: Not all deductions are available for all business classifications.
SCHEDULE B - Credit Details:
List credits to be used with this return. Documentation must be attached.
SCHEDULE C - Excess Tax Collected:
List the excess tax collected by taxable activity.
NOTE:
The line numbers at the top of each column below correspond with the line numbers listed on the front page.
SCHEDULE A
Deduction Description
Ded.
Code
FOR ASSISTANCE, CALL: City of Chandler (480) 782-2280 Fax: (480) 782-2343 or visit our website: chandleraz.gov
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Business Class Code
Line 2
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Line 3 Line 4
Business Class Code Business Class Code
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Sales for Resale
54
Out-of-State Sales
Prescriptions / Prosthetics
Gasoline & Use Fuel
Retail Service Labor
Qualifying Healthcare Sales
Tax Collected or Factored
Interstate Telecommunications
Exempt Capital Equipment
Freight-Out / Delivery
Food Stamps / WIC
Bad debts on which tax was paid
Other (explain)_____________
Other (explain)_____________
SALES TO U.S. GOVERNMENT
50% of Retail
100% of Manufacturing
35% Standard Contracting
Out-Of-City Contracting
Subcontracting Income
Discounts and Refunds
52
55
58
59
63
64
65
66
73
74
79
81
75
75
56
57
70
71
62
CONSTRUCTION CONTRACTING
Total Deductions
(copy totals to front)
SCHEDULE B Credit Details (must attach documentation)
, , .
2. Speculative Builder Credit
(For Taxes Paid By The Contractor)
B
, , .
1. Accounts Receivable Credit
B
License No. Report Period:
Total Schedule B (copy total to front, line 11)
SCHEDULE C Excess Tax Collected
C
, .
Excess Tax by taxable activity
Trade-In Allowances
, . , .
Total Schedule C (copy total to front, line 7)
9412125699
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