Simplified Combined Excise Tax Return Form - Washington Department Of Revenue - 2001 Page 2
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! ! ! ! Step F -
Calculate Total Amount of Credit
Line
Credit
Amount
Credit Classification
I.D.
No.
21
• Enter credits taken on lines 21-25.
Multiple Activities Tax Credit (attach Schedule C)
800
Manufacturing Software/Programming Rural Employment
• On line 26, enter total of any other
22
860
B&O Tax Credit
credits taken and not listed. These
include High Tech credit, Hazardous
23
865
Help Desk Services B&O Tax Credit
Substance credit, Bad Debt credit or
24
Alternatives to Field Burning Credit
857
any other credit. Be sure to attach
appropriate documents for each credit
25
Small Business B&O Tax Credit (see table enclosed)
815
taken.
26
Other Credits (attach appropriate documents)
810
27
Total Credit (add lines 21-26 and transfer to line 29 below)
! ! ! ! Step G -
Itemize Deduction Amounts Taken in Steps A and B
• Enter the amount of deduction taken for each tax classification. Report deductions under the heading that corresponds to your reporting
activity.
• Transfer the total amount of deductions taken under each classification below to the corresponding line number on page 1, Steps A and/or B,
column 2, of your return.
• Deductions taken in Steps A and B, column 2, but not itemized below, will be disallowed.
Line 1-Manufacturing
I.D.
Amount
Line 3-Service & Other
I.D.
Amount
Line 6-Retail Sales Tax
I.D.
Amount
Bad Debts
0701
Bad Debts
0401
Bad Debts
0101
Cash & Trade Discounts
0702
Cash & Trade Discounts
0402
Cash & Trade Discounts
0102
Freight
0703
Interstate & Foreign Sales
0404
Interstate & Foreign Sales
0104
Advances Reimbursements;
Advances Reimbursements;
0707
0407
Tax in Gross
0114
Returns & Allowances
Returns & Allowances
Gambling; Prize; Cash Pay-
Other (Explain):
0799
0410
Sales to U.S. Government
0118
Outs
Certain Initiation Fees;
0411
Motor Vehicle Fuel Sales
0119
Dues; Contributions
Interest on Certain
Presc. Drugs/ Hearing Aids/
0412
0121
Invest/Loan/Obligations
Lenses/ etc
Artistic/Cultural Activities
0416
Exempt Food Sales
0122
Qualified Nonresident Sales
Other (Explain):
0499
0123
TOTAL
TOTAL
Trade-in Allowance
0124
Line 2-Wholesaling
I.D.
Amount
Line 4-Retailing (B&O)
I.D.
Amount
Newspapers
0125
Certain Network Telephone
Bad Debts
0301
Bad Debts
0201
0126
Services
Sales to Indians With Delivery
Cash & Trade Discounts
0302
Cash & Trade Discounts
0202
0128
on the Reservation
Interstate & Foreign Sales
0304
Interstate & Foreign Sales
0204
0129
Sales of Feed to Fish Farmers
Taxable Amount for Tax Paid
Motor Vehicle Fuel Tax
0305
Motor Vehicle Fuel Tax
0205
0130
at Source
Casual Sales;
Advances Reimbursements;
0306
0207
Returns & Allowances
0131
Accommodation Sales
Returns & Allowances
Advances Reimbursements;
Sales to Nonprofit Org. of Artistic/
0307
No Local Activity
0208
0132
Returns & Allowances
Cultural Art Objects for Displays
Casual Sales;
No Local Activity
0308
0213
Ride-Sharing Vans
0134
Accommodation Sales
Purebred Livestock for
Other (Explain):
0399
Tax in Gross
0214
0135
Breeding
Tax Deferral/Investment
Consignment Sales
0215
0136
Certificate No.
Sale of Mfg Machinery/
Artistic/Cultural Activities
0216
0156
Equipment; Install Labor
Presc. Drugs Sold by Pub.
Other (Explain):
0199
0217
Operated/Nonprofit Hosp.
Other (Explain):
0299
TOTAL
TOTAL
TOTAL
DUE DATE: JANUARY 31, 2002
!Step H -
JANUARY 2002
Calculate Amount Owed, Sign and Date
!
5 % Penalty is Assessed After January 31, 2002
S M T W T
F
S
Line
31
Item
Amount
1
2
3
4
5
10% Penalty is Assessed After February 28, 2002
No.
6
7
8
9 10 11 12
20% Penalty is Assessed After April 1, 2002
Total All Tax Due from page 1
13 14 15 16 17 18 19
28
(add lines 5, 13, 17, and 20)
20 21 22 23 24 25 26
If the due date falls on a weekend or legal
27 28 29 30 31
29
Credit (from Step F, line 27, Total Credit)
holiday, the due date for the return is extended
to the next business day.
30
Subtotal (subtract line 29 from line 28)
Penalty ! (minimum $5.00)
31
! ! ! !
Signature
32 TOTAL AMOUNT OWED (add lines 30-31)
! ! ! !
(
)
Date
Ph.
To inquire about the availability of this form in an alternate format for the
visually impaired, please call (360) 486-2342. Teletype (TTY) users may call
! ! ! ! Step I -
Return to Page 1, Bottom Right, and
(800) 451-7985.
Enter Total Amount Owed.
REV 40 2406 A01Simp (11-1-01)
2
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