Form 17 - Wyoming Sales/use Tax Return
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1
2Department of Revenue
Wyoming Sales/Use Tax Return
Herschler Bldg., 122 W. 25th St.
Cheyenne, WY
82002-0110
(Includes Resort Tax)
Form 17
Department
Use ONLY
This Tax Return MUST BE POSTMARKED
Ownership
Ownership
on or before the last day of the month
RID:
Name:
following the date of sale:
PLEASE COMPLETE THIS FORM BY
Report Period:
through
Feb 01, 1996
Feb 29, 1996
HAND - USE BLACK INK ONLY
1.
Gross sales and services
2.
Total deductions
3.
Net taxable sales
(Line 1 minus Line 2)
4. 4. 4. 4. 4.
Sales Tax Collected This Report Period:
Please write neatly inside the boxes!
Please write neatly inside the boxes!
Amount Subject to Tax
Amount Subject to Tax
Tax Due
= = = = =
= = = = =
Tax Due
Tax Rate
Tax Rate
X
X
County
4A.
4B.
County
4A.
4B.
4 D .
4 C .
4 C .
4 D .
6 %
5 %
Natrona
Albany
5 %
6 %
Niobrara
Big Horn
5.25%
5 %
Park
Campbell
02 0 12345
5%
5 %
Platte
Carbon
5 %
6 %
Sheridan
Converse
6 %
4 %
Sublette
Crook
5 %
6 %
Sweetwater
Fremont
5.25 %
6 %
Teton
Goshen
5 %
5 %
Uinta
Hot Springs
5 %
5 %
Washakie
Johnson
6 %
5 %
Weston
Laramie
5 %
4E. Total sales tax due (Column 4D):
Lincoln
Excess Tax ...............................................................................................................................................
5.
Resort Lodging
Tax Rate
esort Lodging Tax Due
6.
x
% = R
Sales
Resort Sales
x Tax Rate
% = Resort Sales Tax Due
7.
8. Resort Use
x Tax Rate
% = Resort Use Tax Due
........................................................................................................
9. TOTAL TAX DUE (Lines 4E +5+6+7+8)
.............................................................................................................................................
10. ADJUSTMENTS
PAY THIS AMOUNT
11. TOTAL DUE
(
)
Lines 9+10
,
,
.
F F F
Rev. 3/29/2007
I declare, under penalty of perjury, that I have examined this return and to the best of my knowledge and belief it is correct and complete.
Authorized
Signature
Title
Date:
/
/
Phone No. (
)
-
If your address has changed, x appropriate box:
Business Location
Mailing Address
Both
New Address:
Has you business permanently closed? Date effective__/__/___(License will be canceled)
Has there been a change in ownership? Date effective__/__/___(License will be canceled)
(For ownership change, please provide name(s) and address of new owner(s) below:
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