City Of Bellevue Business & Occupation Tax Return Form

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MAIL CORRESPONDENCE TO:
CITY OF BELLEVUE
City of Bellevue Tax Division
BUSINESS & OCCUPATION TAX RETURN
PO Box 90012
Bellevue, WA 98009-9012
Please make checks payable to the City of Bellevue
(425) 452-6851
SECTION I: Business Changes
Please note any changes in your business:
MAIL TAX RETURNS TO:
Business closed or sold. Please note date & new owner below.
LOCKBOX
Business moved. Please note new address below.
PO BOX 34372
Address-Location ___ or Mailing ___ Please note new address(es) below.
Phone - Please note new phone number below.
SEATTLE, WA 98124-1372
Entity Change (i.e. Incorporated) - Please note type of change below.
Date Due
Reporting Period
Registration #
SECTION II: Gross Receipts Tax
(Bellevue City Code 4.03 & 4.09)
Tax Classification
Gross Receipts
Deductions
Taxable Receipts
Tax Rate
Tax Due
Code
Column 1
Column 2
Column 3
Column 4
Column 5
Column 6
No.
Manufacturing/
0.001496
1
Processing for Hire
0.001496
2
Wholesaling
Retailing/
0.001496
3
Retail Service
4
Printing/Publishing
0.001496
Extracting/
11
0.001496
Extracting for Hire
6
Service & Other
0.001496
Totals
SECTION III: Deductions-
Code No.
Description of Deductions
Amount
Describe the
reasons and tax classifications for any deductions
reported in Column 3, Section II above (qualified
deductions detailed on the back of this tax return).
SECTION IV: Square Footage Tax (The Square Footage Tax is generally paid by administrative offices and businesses who
take interstate and foreign sales deductions from their gross receipts - see backside for example).
Non-Taxable
Square Footage
Total Sq Feet
Sq Feet
Taxable Sq Feet
Tax Rate
Tax Due
Column 1
Column 2
Column 3
Column 4
Column 5
Column 6
8
Square Footage
SQ. FOOTAGE RATE FOR 2004: Quarterly - .1876; Annual - .7504
SECTION V:
Total Due from
If total taxable units (Column 4) are equal
Sections II & IV
to or less than the following, then no tax is
due:
20
Credit
Penalty
Quarterly
Annual
Gross Receipts
$31,250
$125,000
Interest
Square Footage
250 square feet
Account Balance
Total Due
The interest rate on delinquent returns for
I hereby certify that the statements and information provided on
this tax return are true and complete to the best of my knowledge.
2004 is: 4.00% annually
Signature:
Name:
Title:
Date:
Phone:

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