Fillable Form 04-200 - Tire Fee Quarterly Return (Page 2 of 2) in pdf

Form 04-200 - Tire Fee Quarterly Return Page 2

Download a blank fillable Form 04-200 - Tire Fee Quarterly Return in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 04-200 - Tire Fee Quarterly Return with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Alaska Department of Revenue

State of Alaska Tire Fees

Tax Division

PO Box 110420

Supporting Schedule of Exempt Tire Sales

Juneau, AK 99811-0420

Telephone 907.465.2320

This form is available online at

Fax 907.465.2375

Federal EIN or SSN

AK Business License #

Page

Name

Calendar Quarter Ending

This is a supporting schedule for Alaska Tire Fees Quarterly Return (AS 43.98.025) Form 04-200. Tire sellers must complete this schedule if they sold new

tires, studded tires, or installed studs for exempt purchasers as provided by AS 43.98.025(g). The number of exempt tires sold must agree with the number of

exempt tires & services reported on lines 2 and 8 of Form 04-200. Attach this schedule to your Tire Fees Quarterly Return. Use additional pages as necessary.

Number of Studded

Number of New

Tires Sold & Stud

Name of Exempt Purchaser

Invoice Date

Invoice Number

Tires Sold

Installations

Performed

Totals Carried Forward .................................................................................

Carry forward to line 2, Form 04-200

line 8, Form 04-200