Utility Users Tax Return Form - California Finance Department

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Finance Department
P.O. Box 785
La Habra, California 90633-0785
(562) 905-9700
UTILITY USERS TAX RETURN
Taxpayer:
Name
Address
City, State, Zip
Reporting Period:
Tax Due Date:
(twentieth day of the month following the reporting period)
Revenue:
$
Utility Users Tax due:
6%
$
Total Remittance:
$
Contact Person:
Phone Number:
Signature:
Title:
Date:

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