Form Ador 20-1046 - Transaction Privilege, Use And Severance Tax Return
ADVERTISEMENT
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4TRANSACTION PRIVILEGE, USE AND SEVERANCE TAX RETURN (TPT-1)
.
STATE LICENSE NO
100
ARIZONA DEPARTMENT OF REVENUE
TAXPAYER IDENTIFICATION NO.
PO BOX 29010, PHOENIX, AZ 85038-9010
E I N
MAILING ADDRESS CORRECTION REQUESTED
S S N
PERIOD COVERED
FROM
THROUGH
THIS RETURN MUST BE FILED EVEN IF YOU HAD NO SALES ACTIVITY
PAGE
OF
FILING FREQ
THESE AREAS FOR DEPARTMENT USE ONLY
TRAN
00
CODE
PAY
00
TYPE
ORIGINAL BD#
BD#
BUSINESS NAME: ___________________________________________________
C/O: _______________________________________________________________
ADDRESS: _________________________________________________________
CITY/STATE/ZIP CODE: _____________________________________________
POSTMARK
RECEIPT
Check if mailing address has changed
COLUMN 3 X COLUMN 4 = COLUMN 5
COLUMN 3 X COLUMN 6 = COLUMN 7
COLUMN 6
COLUMN 1
COLUMN 2
COLUMN 3
COLUMN 4
COLUMN 5
COLUMN 7
L
Region
Business
= Accounting
I
Accounting
Code
Gross
- Deductions
= Net Taxable
X Tax Rate
= Tax Amount
Business Description
Class
Credit
Credit Rate
N
1
2
3
4
5
6
7
8
9
10
11
12
SUBTOTAL
***
***
13
STATE EXCESS
ENTER EXCESS STATE TAX COLLECTED
PLUS
(+)
TTT
09
14
PLUS
OTHER EXCESS
TTT
10
ENTER OTHER EXCESS TAX COLLECTED
(+)
15
GRAND TOTAL
16
TTT
20
EQUAL
ACCOUNTING CREDIT from line 16 column 7 .................
MINUS
(-)
25
17
PENALTY & INTEREST (see instructions) ........................
PLUS
(+)
30
18
ENTER TOTAL LIABILITY ................................................
EQUAL
35
19
ENTER CREDIT BALANCE TO BE APPLIED ..................
MINUS
(-)
40
20
ENTER ESTIMATED PAYMENTS TO BE USED .............
MINUS
(-)
45
21
ENTER NET AMOUNT DUE .............................................
99 EQUAL
22
Paid Preparer's Signature (other than taxpayer)
Under penalties of perjury, I declare that I have examined this return, including
accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. Declaration of preparer (other than taxpayer)
is based on all information of which preparer has any knowledge.
Paid Preparer's EIN or SSN
Taxpayer's Signature
Date
Please make check payable to: ARIZONA DEPARTMENT OF REVENUE
FOR THIS AMOUNT
( TPT-1 ) (12/00)
ADOR 20-1046
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