Sales/use Tax Return Form - City Of Greeley Page 2

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SCHEDULE - B - CITY USE TAX
SCHEDULE - C - CONSOLIDATED ACCOUNTS REPORT
This schedule is required in all cases in which the taxpayer makes a consolidated return which includes
The Greeley Municipal Code imposes a tax upon the privilege of using, storing, distributing or
sales made at more than one location. It must be completely filled out and convey all information
consuming in the City tangible property or taxable services purchased, rented or leased.
required in accordance with the column headings.If additional space is needed attach schedule in same
format.
PERIODS TOTAL GROSS
PERIODS NET TAXABLE
DATE OF
NAME OF VENDOR
TYPE OF COMMODITY
PURCHASE
ACCOUNT
BUSINESS ADDRESSES
SALES (AGGREGATE TO
SALES (AGGREGATE TO
PURCHASE
ADDRESS
PURCHASED
PRICE
NUMBER
OF CONSOLIDATED ACCOUNTS
LINE 1 FRONT OF RETURN)
LINE 4 FRONT OF RETURN)
$
$
(A) LIST OF PURCHASES (IF ADDITIONAL SPACE NEEDED-ATTACH SCHEDULE IN SAME FORMAT)
$
(B) TOTAL PURCHASE PRICE OF PROPERTY SUBJECT TO CITY USE TAX
ENTER TOTAL LINE (B) ON LINE 11 ON FRONT OF RETURN
$
$
$
ENTER TOTALS HERE AND ON FRONT OF RETURN
SHOW BELOW CHANGE OF OWNERSHIP, NAME AND/OR
I hereby certify under penalty of perjury, that the statements
1. If ownership has changed, give date of change and new owner’s name
NEW BUSINESS DATE
ADDRESS.
made herein are to the best of my knowledge, true and correct.
2. If business has been permanently discontinued, give date discontinued
MO.
DAY
YR.
3. If business location has changed, give new address
BY
4. Records are kept at what address?
COMPANY
5. If business is temporarily closed, give dates to be closed
DISCONTINUED DATE
6. If business is seasonal, give month of operation
PHONE
MO.
DAY
YR.
7. If the return includes sales for more than one location, refer to and
complete schedule "C"
BUS ADDRESS
MAILING ADDRESS
TITLE
DATE
SCHEDULE - B - CITY USE TAX
SCHEDULE - C - CONSOLIDATED ACCOUNTS REPORT
This schedule is required in all cases in which the taxpayer makes a consolidated return which includes
The Greeley Municipal Code imposes a tax upon the privilege of using, storing, distributing or
sales made at more than one location. It must be completely filled out and convey all information
consuming in the City tangible property or taxable services purchased, rented or leased.
required in accordance with the column headings.If additional space is needed attach schedule in same
format.
PERIODS TOTAL GROSS
PERIODS NET TAXABLE
DATE OF
NAME OF VENDOR
TYPE OF COMMODITY
PURCHASE
ACCOUNT
BUSINESS ADDRESSES
SALES (AGGREGATE TO
SALES (AGGREGATE TO
PURCHASE
ADDRESS
PURCHASED
PRICE
NUMBER
OF CONSOLIDATED ACCOUNTS
LINE 1 FRONT OF RETURN)
LINE 4 FRONT OF RETURN)
$
$
(A) LIST OF PURCHASES (IF ADDITIONAL SPACE NEEDED-ATTACH SCHEDULE IN SAME FORMAT)
$
(B) TOTAL PURCHASE PRICE OF PROPERTY SUBJECT TO CITY USE TAX
ENTER TOTAL LINE (B) ON LINE 11 ON FRONT OF RETURN
$
$
$
ENTER TOTALS HERE AND ON FRONT OF RETURN
SHOW BELOW CHANGE OF OWNERSHIP, NAME AND/OR
I hereby certify under penalty of perjury, that the statements
1. If ownership has changed, give date of change and new owner’s name
NEW BUSINESS DATE
ADDRESS.
made herein are to the best of my knowledge, true and correct.
2. If business has been permanently discontinued, give date discontinued
MO.
DAY
YR.
3. If business location has changed, give new address
BY
4. Records are kept at what address?
COMPANY
5. If business is temporarily closed, give dates to be closed
DISCONTINUED DATE
6. If business is seasonal, give month of operation
PHONE
MO.
DAY
YR.
7. If the return includes sales for more than one location, refer to and
complete schedule "C"
BUS ADDRESS
MAILING ADDRESS
TITLE
DATE

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