Form Rev 86 0059 - Leasehold Excise Tax Return Federal Permit Or Lease - 2009 Page 3
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1
2
3
4Leasehold Excise Tax Return
Washington State
Annual 2009
A/09
Department Of Revenue
Federal Permit or Lease
Special Programs Division
PO Box 47464
Olympia, WA 98504-7464
Keep This as Your Copy
Show Changes in Address or Ownership
Instructions
1. Column 1 (Tax Area Code) must contain the Tax
4. Multiply column 3 (Taxable Rent Due) by the 12.84%
Area Code (Levy Code) for each federal permit or
(.1284) tax rate and enter this amount in the Total
lease. This can be requested from the county
Tax Due, and pay this amount.
assessor’s office in the county where the property is
located or may be obtained from the personal
5. Leasehold Excise Tax Returns are due 15 days after
property statement if applicable. (This code is used to
the permit or lease fee is due to the Forest Service or
distribute the tax back in the area where the leased
lessor.
property is located.) If a single permit or lease
▪
If payment is made 30 days after the due date
extends into more than one tax area, enter each tax
please include a 5% delinquent penalty.
area code as if it represents a single lease. Rent
▪
If payment is made 60 days after the due date
should be apportioned between areas on the basis of
please include a 15% delinquent penalty.
approximate property value within each area.
▪
If payment is made 90 days after the due date
please include a 25% delinquent penalty.
2. Column 2 (Location Code) must contain the proper
code for the location of the property leased. Location
6. Attach remittance made payable to the Washington
codes may be obtained from the listing on page 4.
State Department of Revenue.
3. For each permit or lease, enter in column 3 (Taxable
7. Sign and date page 1
Rent Due) the amount of taxable rent. This is the
8. Should you have questions regarding your tax liability,
amount paid to the Federal Government for the
please call the Department of Revenue at
permit fee.
(360) 570-3265 option 4.
(4)
(1)
(2)
(3)
Tax Code Area**
Location Code
Taxable Rent Due
Total Tax Due
(on back)
(.1284 X Taxable Rent)
Total Tax Due
*Add Penalty if Applicable
4
Signature
Total Payment Enclosed
Phone Number (
)
4
Date
/
/
For tax assistance, visit dor.wa.gov or call (360) 570-3265. To inquire about the availability of this document in an alternate format for the visually impaired,
please call (360) 705-6715. Teletype (TTY) users may call 1-800-451-7985.
REV 86 0059
(1/6/09)
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Parent category: Financial