Application For Business Tax And License And Report To County Clerk As Required By Section 67-4-715 Tennessee Code Annotated - 2008 Page 8

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Schedule A
Deductions for Business Tax Purposes
Deductions must have adequate records of support to qualify.
Part A
1.
Sales of services substantially performed in other States
1
2.
The proceeds of the sale of goods, wares, or merchandise returned by the customer when the sales price is
refunded either in cash or in credit. Line E, Schedule A, State Sales Tax Return
2
Bona Fide Sales in Interstate Commerce where the purchaser takes possession outside of Tennessee for use
3.
or consumption outside of Tennessee and item is actually delivered by the seller of common carrier.
3
4.
Cash discounts allowed and taken on sales; Amounts allowed at trade-in value for any article sold. Line C,
Schedule A, State Sales Tax Return
4
5.
Repossessions--Enter that portion of the unpaid principal balances in exess of $500.00 due on tangible
personal properties repossessed from customers. (Line H, Schedule A, State Sales Tax Return.)
5
Amounts subcontracted to other persons for additions or improvements to real property. Attach list of
6.
subcontractors and addresses, items subcontracted and amounts.
6
TOTAL - Part A -
add lines 1-6
7.
7
Part B
1.
FUEL TAX
a. Gasoline Tax Paid:
# of Gallons
Federal
State
b. Diesel Fuel:
# of Gallons
Federal
State
c. State Special Tax:
# of Gallons
Federal
d. Kerosene:
# of Gallons
e. Liquefied Gas:
# of Gallons
Federal
State
2.
TOBACCO TAX
TOTAL B(1)
a. Cigarettes:
# 20 Packs
Federal
# 25 Packs
State
b. Other Tobacco Products:
Federal
State
3.
BEER
TOTAL B(2)
a. Beer:
Gallons
Barrels
Federal
State
b. 17% of Wholesaler's Cost per beer sold:
4.
OTHER DEDUCTIONS
TOTAL B(3)
Other:
TOTAL B(4)
TOTAL -- Part B -- add Totals for B(1)-B(4)
TOTAL PART B
Part C
TOTALS Parts A and B
Add Part A and Part B Totals and place on Line 2 on front side of report
MULTIPLE LOCATIONS
If return is filed for more than one location, list locations separately below along with requested information.
Street, Address, City, State, Zip
Gross Sales
Deductions
1. Gross Taxable Sales for Tax Purposes to the State of Tennessee
$
Sales Tax
2. Total Amount of Deductions for State Sales Tax Purposes for Tax Period (from Schedule A on the State Tax Return)
$
Reports
3. Total Amount of Sales Tax Due State for Tax period. (Line 14 State Tax return)
$
The amounts reflected above should equal the total of these items on all State Sales and Use Tax Returns for tax period, including any monthly returns which may be delinquent.
Payment for the amount of business tax due may be made by cash, check, or credit card
(VISA, MasterCard or Discover).
If using a credit card, please enclose a Credit Card Authorization Form.

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