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SD EForm -1934V9HELPComplete and use the button at the end to print for mailing.SALES AND USE TAX RETURNReporting PeriodReturnReturn DueCHECK FOR CHANGE OF ADDRESS BELOWCheck if out of businessLast day of business:License #SALES TAX CALCULATIONS1. Gross SalesGROSSTAXABLERATETAX DUE2. Use Taxable3. Non-Taxable Sales4. Special Jurisdiction Sales (Detail in City Section) 0.00 0.00 x 4%5. Net State Sales Taxable (Line 1 plus Line 2, minus Line 3, minus Line 4)6. City & Special Jurisdiction Tax Calculation Detail:7.City/Special Jurisdiction NameCodeTaxableRateTax 2. Total City/Special Jursidiction Tax (Add Lines 8 through 21) 0.0023. Total Tax Due (Line 5 plus Line 22) 0.0024. 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 12/05PRINT FOR MAILINGCLEAR FORM

SD EForm - 1934V9HELPComplete and use the button at the end to print for mailing.License NumberReturn PeriodDate FiledAmount PaidCheck NumberDepartment ofevenue &egulationRSALES TAX RETURN WORKSHEET/INSTRUCTIONSThis worksheet is for your records only. Be careful to transfer the correct figures to the actual tax return.Additional worksheets can be obtained by contacting your nearest Department of Revenue & Regulation office or at ourwebsite: s.htmSales 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 purchased to be resold, if purchaser provided an Exemption Certificate. Sales of tangible personal property delivered to a locationoutside South Dakota. Services are taxed where the customerreceives 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. 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.3.4. Spec Juris Sales (Detail in City Section)Special Jurisdictions include the Cheyenne River, Oglala, Rosebud,and Standing Rock Special Jurisdictions. Taxable sales in SpecialJurisdictions are included in Line 1 and deducted on Line 4. Reportthese sales in the City and Special Jurisdiction tax calculation areausing the code for the Special Jurisdiction the sales was made in.(See Tribal Tax Facts for details.)4.5. Net State Sales TaxableAdd Lines 1 and 2 and Subtract Lines 3 and 4.5.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 collect from your customers. 0.00A return MUST be filed even if no tax is due.(Continue on reverse side)x 4% 0.00

6. City & Special Jurisdiction Tax Calculation Detail7. City/Special Jurisdiction NameCodeTaxableRateTax .0020. Total City/Special Jurisdiction Tax (Add lines 8 through 21)The listing for each city or Special Jurisdiction along with itscorresponding code, rate, net taxable, and tax due must be listedon the return that will be filed. Use the worksheet to record thisinformation for your file.22. 0.0023. Total Tax DueTotal tax due is calculated by adding Lines 5 and 2223. 0.0024. Penalty/Interest24.25. Adjustment (Previous Credit/Balance Due)Credit balance should be listed as a negative amount, BalanceDue should be listed as a positive amount.25.26. Total Due (Lines 23 plus 24 plus 25)Total amount owing is calculated: Add lines 23, 24 and 25.26.27. Amount RemittedEnter amount of the remittance attached and make all remittancespayable to the South Dakota State Treasurer.Thank You.27.Interest: 1.25% (.0125) of the tax liability each month or partthereof for a return filed or any tax unpaid after the due date (aminimum of 5.00 is due each month). Penalty: 10% (.10) of thetax liability (minimum 10.00, even if no tax is due) is assessed if areturn is not received within 30 days following the month the return is due.NOTE: 0.00Both the preparer of the return and the licensee MUST sign and date the return. You must file a returneven 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 reversibleenvelope.PRINT FOR MAILINGCLEAR FORM

South Dakota Dept. of Revenue - Municipal/Special Jurisdiction Tax ScheduleReporting PeriodLicense *Astoria*Aurora*Avon*Baltic*BalticBelle Fourche*Belle FourcheBelvidere*Beresford*BeresfordBig Stone City*Bison*Blunt*BluntBonesteel*Bowdle*Box Elder*Box o*Burke*Camp al Net Taxable SalesRV-083 July - December 0%2.0%2.0%2.0%1.0%2.0%2.0%1.0%2.0%1.0%2.0%Column A Tax Due City-Clear LakeClear avis*Deadwood*DeadwoodDell Rapids*Dell RapidsDelmont*De Smet*De SmetDimockDoland*Dupree*Eagle Butte*Eagle ButteEden*Edgemont*EdgemontEgan*Elk Point*Elk t Pierre*Fort sonGary*Gayville*Geddes*Gettysburg*Gettysburg* Indicates the General 2-1Net Taxable Sales%Column A Tax 2.0%1.0%2.0%2.0%1.0%1.0%2.0%2.0%2.0%1.0%Bold Indicates the Gross Receipts Rate-

South Dakota Dept. of Revenue - Municipal/Special Jurisdiction Tax ScheduleReporting PeriodLicense HighmoreHill City*Hill CityHitchcock*Hosmer*Hot Springs*Hot 2172-2174-2175-2175-1176-2177-2177-1179-2Net Taxable mball*KimballKranzburg*La Bolt*Lake Andes*Lake Norden*Lake .0%2.0%RV-083 July - December 2013%Column A Tax Due onMarion*Martin*MartinMcCook dgeMonroe*Montrose*Morristown*Mound City*Mount Vernon*Mount VernonMurdo*MurdoNew Underwood*Newell*Nisland*North Sioux 27-1Net Taxable Sales%Column A Tax Due2.0%2.0%2.0%1.0%2.0%1.0%2.0%2.0%1.0%Report Under North Sioux %1.0%2.0%2.0%2.0%2.0%-- North Sioux nn*Quinn* Indicates the General RateBold Indicates the Gross Receipts Rate

South Dakota Dept. of Revenue - Municipal/Special Jurisdiction Tax ScheduleReporting PeriodLicense #CityCodeRamona*Rapid CityRapid coe*Rosholt*Roslyn*Saint LawrenceSalem*SalemScotland*Selby*Sherman*Sioux Falls*Sioux FallsSisseton*SissetonSouth mmit*Tabor*Tea*TeaTimber ey 367-2368-2369-2370-2372-2372-1373-2375-2376-2Net Taxable SalesRV-083 July - December %2.0%2.0%2.0%2.0%2.0%1.0%1.0%2.0%2.0%Column A Tax Due erWentworth*Wessington*Wessington Springs*White*White Lake*White LakeWhite River*Whitewood*WhitewoodWillow cket*Worthing*WorthingYaleYankton*YanktonCodeNet Taxable mn A Tax .0%1.0%2.0%1.0%-TOTAL COLUMN AOTHER TAXESTaxCodeTelecommunicationTourism TaxMotor VehicleSioux Falls Lodging900-1700-1600-1800-1Net Taxable Sales%Column A Tax Due4.0%1.5%4.5%1.0%-Total Other TaxesSpecial Jurisdiction TaxCodeCheyenne SalesCheyenne ExciseCheyenne TourismCrow Creek SalesCrow Creek ExciseCrow Creek TourismPine Ridge SalesPine Ridge ExciseRosebud SalesRosebud ExciseRosebud seton Wahpeton UseSisseton Wahpeton ExciseStanding Rock SalesStanding Rock ExciseStanding Rock TourismYankton UseYankton ExciseNet Taxable Sales%Column A Tax %2.0%4.0%2.0%1.5%4.0%2.0%Total Special Jurisdiction TaxesGRAND TOTAL* Indicates the General RateBold Indicates the Gross Receipts Rate--

SALES AND USE TAX RETURN License # RV11STRTN 12/05 SALES TAX CALCULATIONS GROSS TAXABLE RATE TAX DUE 1. Gross Sales 2. Use Taxable 3. Non-Taxable Sales 4. Special Jurisdiction Sales (Detail in City Section) 5. Net State Sales Taxable (Line 1 plus Line 2, minus Line 3, minus Line 4) . Feed for

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