SALES AND USE TAX RETURN - Zillionforms

SD EForm -1934V12HELPComplete and use the button at the end to print for mailing.SALES AND USE TAX RETURNReporting PeriodReturnReturn DueIf your address changed, please update below:Mailing Address:Physical Address:Out of business? Last day of business:Please send your license card in with your return.License #SALES TAX CALCULATIONS1. Gross SalesGROSSTAXABLERATETAX DUE2. Use Taxable3. Non-Taxable Sales4. Special Jurisdiction Sales (Detail in City Section)5. Subtotal (Line 1 plus Line 2 minus Lines 3 and 4) 0.006. Net State Sales Taxable beginning June 1, 20167. Net State Sales Taxable through May 31, 2016 (Line 5 minus Line 6) 0.00 x 4.5% 0.00x 4.0% 0.008. Total State Tax Due (Line 6 Tax Due plus Line 7 Tax Due)9. City and Special Jurisdiction Tax Calculation Detail:10. 0.00CodeCity/Special Jurisdiction NameTaxableRateTax 8.0.0019.0.0020.0.000.00 0.0014.21.22. Total City/Special Jurisdiction Tax (Add lines 11 through 21) 0.0023. Total Tax Due (Line 8 plus Line 22)24. Penalty/Interest25. Adjustment (Previous Credit/Balance Due) 0.0026. Total Due (Line 23 plus Line 24 plus Line 25)27. Amount RemittedI declare under the penalties of perjury this return has been examined by me and to the best of my knowledge and belief is a true,correct and complete return.DatePreparerDateLicenseeRV11STRTN 03/16PRINT FOR MAILINGCLEAR FORM

SD EForm -1934V12HELPComplete and use the button at the end to print for mailing.License NumberReturn PeriodDate FiledAmount PaidCheck NumberSALES TAX RETURN WORKSHEET AND INSTRUCTIONSThis worksheet is for your records only. Be careful to transfer the correct figures to the actual tax return. Additional worksheets can beobtained by calling the Department of Revenue at 1-800-829-9188 or at our website: http://dor.sd.gov/Taxes/Business Taxes/Forms/Sales Tax Forms.aspx. Create an EPath account at http://sd/gov/epath. Please remember that a return must be filed even if tax is not due.Sales Tax Calculation1. Gross Sales1.2. Use TaxableUse tax is due on the cost of tangible personal property or serviceswhen no sales tax was paid on the purchase. Use taxable itemsmay include items removed from inventory for business or personaluse, donated items, products or services purchased from unlicensed vendors through mail-order or the Internet.2.3. Non-Taxable Sales Sales of products or services sold for resale, if purchaserprovided an Exemption Certificate. Sales of products delivered to a location outside South Dakota.Services are taxed where the customer receives the service. Sales to United States Government, State of South Dakota,Indian Tribes, county or local governments in South Dakota,Nonprofit Hospitals, Government owned Schools, Paymentmust be directly from government funds.3.Gross sales must include all taxable and non-taxable sales oftangible personal property and services made in the current monthor months, including Special Jurisdiction sales.Do not include sales tax collected from your customers. Motor Fuel subject to Motor Fuel tax or if used for ag purposes.Feed for livestock, horses and poultry. (Pet feed is taxable.)Returned merchandise, video lottery and lottery ticket sales,fishing and hunting license fees, bad debts, WIC and foodstamp purchases.4. Spec Juris Sales (Detail in City Section)Special Jurisdictions include the Cheyenne River, Crow Creek,Oglala, Rosebud, and Standing Rock Special Jurisdictions.Taxable sales in Special Jurisdictions are included in Line 1 anddeducted on Line 4. Report these sales in the City and SpecialJurisdiction tax calculation area using the code for the SpecialJurisdiction the sales were made in.(See Tribal Tax Facts fordetails.)4.5. SubtotalAdd Lines 1 and 2 and Subtract Lines 3 and 4. 0.006. Net State Sales Taxable beginning June 1, 20166.1 0.00 x 4.5%6.2 0.007. Net State Sales Taxable through May 31, 20167.1x 4.0%7.2 0.008. Total State Tax Due (Add Lines 6.2 and 7.2) 0.00

9. City & Special Jurisdiction Tax Calculation Detail10. City/Special Jurisdiction NameCodeTaxableRateTax 0018.0.0019.0.0020.0.0021.0.0022. Total City/Special Jurisdiction Tax (Add lines 11 through21) The listing for each city or Special Jurisdiction along with itscorresponding code, rate, net taxable, and tax due must belisted on the return that will be filed. Use the worksheet torecord this information for your file. 0.0023. Total Tax DueTotal tax due is calculated by adding Lines 8 and 22 0.0024. Penalty/InterestInterest: 1% (.01) interest will be assessed each month on any past due taxuntil the tax is paid in full. (A minimum of 5.00 interest is due the firstmonth). (1.25% interest is assessed for each month tax is unpaid prior to July2016.)Penalty: 10% (.10) of the tax liability (minimum 10.00, even if no tax is due)is assessed if a return is not received within 30 days following the month thereturn is due.25. Adjustment (Previous Credit/Balance Due)Credit balance should be listed as a negative amount, BalanceDue should be listed as a positive amount.26. Total Due (Lines 23 plus 24 plus 25)Total amount owing is calculated: Add lines 23, 24 and 25. 0.0027. Amount RemittedEnter the amount of your check.Make check payable to the South Dakota Treasurer.Thank You.A return MUST be filed even if no tax is due.Do not staple or paper clip your check to the return.Be sure to mail your return and payment in the reversible envelope.PRINT FOR MAILINGCLEAR FORM

South Dakota Department of Revenue - Municipal / Special Jurisdiction Tax ScheduleReporting Period:MunicipalityCodeLicense #:Net Taxable Sales%Calculated TaxMunicipalityCodeNet Taxable Sales%Calculated 2006-22.0%1.0%2.0%2.0% 0%2.0%1.0%2.0% -Alexandria*Alpena*007-2009-22.0%1.0% -ColtonColumbia*078-1079-21.0%2.0% -Andover*011-22.0% -Conde*080-22.0% -Arlington*Armour*013-2014-22.0%2.0% -Corona*Corsica*081-2082-22.0%2.0% -Artesian*Ashton*015-2016-22.0%2.0% -CorsicaCrooks*082-1087-21.0%2.0% -Astoria*Aurora*017-2019-22.0%1.0% -CrooksCuster*087-1088-21.0%2.0% -Avon*020-22.0% -Custer088-11.0% -Baltic*022-22.0% -Dallas*089-22.0% -BalticBelle Fourche*022-1027-21.0%2.0% -DallasDavis*089-1091-21.0%2.0% -Belle FourcheBelvidere*027-1028-21.0%2.0% -Deadwood*Deadwood093-2093-12.0%1.0% -Beresford*029-22.0% -Dell Rapids*094-22.0% -BeresfordBig Stone City*029-1031-21.0%2.0% -Dell RapidsDelmont*094-1095-21.0%2.00% -Bison*Blunt*032-2034-22.0%1.0% -De Smet*De Smet092-2092-12.0%1.0% -BluntBonesteel*034-1035-21.0%2.0% -Dimock*Doland*097-2098-22.0%2.0% -Bowdle*036-22.0% -Dupree*101-21.0% -Box Elder*037-22.0% -Eagle Butte*102-22.0% -Box ElderBrandon*037-1039-21.0%2.0% -Eagle ButteEden*102-1103-21.0%1.0% -BrandonBrandt*039-1040-21.0%2.0% -Edgemont*Edgemont104-2104-12.0%1.0% -Bridgewater*Bristol*042-2043-22.0%2.0% -Egan*Elk Point*105-2106-22.0%2.0% -Britton*044-22.0% -Elk Point106-11.0% -BrittonBrookings*044-1045-21.0%2.0% -Elkton*Emery*107-2110-22.0%2.0% -BrookingsBruce*045-1046-21.0%1.0% -Estelline*Ethan*113-2114-22.0%2.0% -Bryant*047-22.0% -Eureka*115-22.0% -Buffalo*Buffalo Chip*048-2030-22.0%2.0% -Fairfax*Fairview*117-2118-22.0%2.0% -Burke*053-22.0% -Faith*119-22.0% -Camp Crook*Canistota*054-2055-21.0%2.0% -FaithFaulkton*119-1121-21.0%2.0% -CanistotaCanova*055-1056-21.0% 1.95% -Flandreau*Flandreau125-2125-12.0%1.0% -Canton*057-22.0% -Florence*126-22.0% -CantonCarthage*057-1061-21.0%2.0% -Fort Pierre*Fort Pierre129-2129-12.0%1.0% -Castlewood*Cavour*062-2063-22.0%2.0% -Frankfort*Frederick*131-2132-22.0%1.0% -Centerville*065-22.0% -Freeman*133-22.0% -CentervilleCentral City*065-1066-21.0%2.0% -Garretson*Garretson138-2138-12.0%1.0% -Chamberlain*067-22.0% -Gary*139-21.0% -ChamberlainChancellor*067-1068-21.0%2.0% -Gayville*Geddes*140-2141-22.0%2.0% -ChancellorClark*068-1073-21.0%2.0% -Gettysburg*Gettysburg142-2142-12.0%1.0% -Clear Lake*075-22.0% -Glenham*145-22.0% -Clear Lake075-11.0% -Gregory*147-22.0% -RV-083 June 1 - 30, 2016* Indicates General RatesBold indicates Municipal Gross Receipts Tax (MGRT) Rates

South Dakota Department of Revenue - Municipal / Special Jurisdiction Tax ScheduleReporting Period:MunicipalityCodeLicense #:Net Taxable Sales%Calculated TaxMunicipalityCodeNet Taxable Sales%Calculated TaxGregory147-11.0% -Letcher*210-22.0% -Grenville*148-22.0% -Letcher210-11.0% -Groton*Groton149-2149-12.0%1.0% -Madison*Madison221-2221-12.0%1.0% -Harrisburg*Harrisburg151-2151-12.0%1.0% -Marion*Martin*226-2227-22.0%2.0% -Harrold*Hartford*153-2154-22.0%2.0% -MartinMcCook Lake*227-11.0% Report under North Sioux City* 258-2-Hartford154-11.0% -McIntosh*219-22.0% -Hayti*Hazel*156-2157-22.0%1.0% -McLaughlin*Mellette*220-2232-21.0%2.0% -Hecla*Henry*158-2159-21.0%1.0% -Menno*Midland*233-2234-22.0%2.0% -Hermosa*160-22.0% -Milbank*235-22.0% -Herreid*161-22.0% -Milbank235-11.0% -Highmore*Highmore164-2164-12.0%1.0% -Miller*Miller237-2237-12.0%1.0% -Hill City*Hill City165-2165-12.0%1.0% -Mission*Mitchell*239-2242-22.0%2.0% -Hitchcock*Hosmer*166-2168-21.0%2.0% -MitchellMobridge*242-1243-21.0%2.0% -Hot Springs*169-22.0% -Mobridge243-11.0% -Hot SpringsHoven*169-1171-21.0%2.0% -Monroe*Montrose*244-2245-22.0%2.0% -Howard*Hudson*172-2174-22.0%2.0% -Morristown*Mound City*246-2247-21.0%2.0% -Humboldt*175-22.0% -Mount Vernon*248-22.0% -HumboldtHurley*175-1176-21.0%2.0% -Mount VernonMurdo*248-1250-21.0%2.0% -Hurley176-11.0% -Murdo250-11.0% -Huron*Huron177-2177-12.0%1.0% -New Effington*New Underwood*252-2254-22.0%2.0% -Interior*179-21.9% -Newell*255-22.0% -Ipswich*181-22.0% -Nisland*256-22.0% 4-2185-22.0%1.0%1.0%2.0%2.0% -North Sioux City*North Sioux .0%1.0%2.0%1.0%2.0% -Jefferson*186-22.0% -Olivet*267-21.0% -Kadoka*Kadoka187-2187-12.0%1.0% -Onida*Orient*269-2272-22.0%1.0% 192-12.00%1.0%2.0%1.0% -22.0%2.0%1.0%2.0% -Kimball*Kimball193-2193-12.0%1.0% -Philip*Pickstown*280-2281-22.0%2.0% -Kranzburg*La Bolt*194-2196-22.0%1.0% -Piedmont*Pierpont*282-2283-22.0%2.0% -Lake Andes*197-22.0% -Pierre*284-22.0% -Lake Norden*199-21.0% -Pierre284-11.0% -Lake Preston*Langford*200-2202-22.0%2.0% -Plankinton*Platte*286-2287-22.0%2.0% -Lead*Lead204-2204-12.0%1.0% -PlattePollock*287-1288-21.0%2.0% 206-1207-2207-1208-2209-22.0%1.0%2.0%1.0%2.0%2.0% -2294-2295-2295-1297-22.0%2.0%2.0%1.0%1.0%1.0% -RV-083 June 1 - 30, 2016* Indicates General RatesBold indicates Municipal Gross Receipts Tax (MGRT) Rates