Et-400 - Arkansas Excise Tax Report Form January 2008 Page 3

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Supplemental Local Sales and Use Tax Schedule
Permit Number:
________________________
Use whole dollars only
Reporting Period: ________________________
Use blue or black ink only
Tax
Taxable Sales
Less: 2%
Local Cap
For Office
C. Type
D. & Purchases
G. Discount
H. Rebate
Use Only
A. City & County
B. Code
E. Rate
F. Gross Tax Due
I. Net Tax Due
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
SALES
USE
TOTAL LOCAL TAX DUE (include in total of Block 4 of ET-400 Form)
Rev 01/2008
ET-400 (Schedule L)

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