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Indiana Utility Receipts Tax Return URT-1 - Indiana
| Indiana Utility Receipts Tax Return Form. This is a Indiana form and can be used in Corporate Income Department Of Revenue Statewide . |
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Form 51102 URT-1 State Form (R8 / 8-12) 2012 Indiana Utility Receipts Tax Return Calendar Year Ending December 31, 2012 or Other Tax Year 2012 and Ending Check box if name changed. Federal Identification Number County State ZIP Code Principal Business Activity Code Telephone Number ( ) No Indiana Department of Revenue Beginning Check box if amended. Name Street Address City K Check accounting method used: Cash Accrual L Do you have on file a valid extension of time to file your return (federal Form 7004 or an electronic extension of time)? Yes M Check all boxes that apply to entity: Initial Return Final Return Consolidated Return Taxable Receipts for Indiana (list utility receipts received during your taxable year) 1. Retail sale of utility services ........................................................................................................................................................... 2. Judgments or settlements as compensation for lost retail sales ................................................................................................... 3. Sales to a reseller if utility is used in hotels, mobile home parks, or marinas ............................................................................... 4. Sales of water or gas to another for rebottling ............................................................................................................................... 5. Installation, maintenance, repair, equipment, or leasing services provided and charges for removal......................................... 6. All other receipts not segregated between retail and nonretail transactions ................................................................................ 7. Total Taxable Receipts (add lines 1 through 6) ........................................................................................................................... Deductions 8. Annual taxpayer deduction ($83.33 per month, not to exceed $1,000 in a taxable year)............................................................. 9. Bad debts on utility receipts of an accrual basis taxpayer ............................................................................................................. 10. Depreciation on resource recovery systems prorated for amount attributed to taxable year....................................................... 11. Receipts exempt from taxation if included in taxable receipts for the Mobile Telecommunications Sourcing Act or IC 6-8.1-15. .................................................................................................................................................................................. 12. Amount paid on customarily returned empty reusable containers ................................................................................................ 13. Receipts from sale of bottled water or gas that was previously taxed .......................................................................................... 14. Total Deductions (add lines 8 through 13) ................................................................................................................................... 15. Indiana Taxable Utility Receipts (subtract line 14 from line 7)................................................................................................... Tax and Credits 16. Utility Receipts Tax Due for the Taxable Year: Multiply the amount on line 15 by 1.4% (.014)................................................ 17. Sales/Use Tax Due on purchases subject to use tax (from worksheet) ....................................................................................... 18. Estimated payments made for utility receipts tax (list quarterly URT-Q payments below) Qtr. 1___________ Qtr. 2___________ Qtr. 3___________ Qtr. 4___________ Enter Total ....... 19. Prior year overpayment credit ___________ and this year's extension payment ___________ Enter Total... ................ 20. Enter name of other tax credit ________________________________________ Code No. a ____ ____ ____ 21. Total Payments and Credits (add lines 18 through 20b) ................................................................................... .......................... 22. Net Tax Due (subtract line 21 from the sum of lines 16 and 17 if line 21 is greater, proceed to lines 23 and 27) ....................... 23. Penalty for underpayment of estimated tax (from completed Schedule URT-2220) .................................................................... 24. Interest: If payment is made after the original due date, add interest (for rates, refer to Department Notice #3).. ...................... 25. Penalty for late payment: See instructions ..................................................................................................................................... 26. Total Amount Owed (add lines 22 through 25) ............................................................................................................................ 27. Overpayment (line 21 minus lines 16, 17, and 23-25) ................................................. .................................................................. 28. Refund (portion of amount on line 27 to be refunded)...................................................................................................................... 29. Overpayment Credit (carry over to the following year's estimated URT account, line 27 minus line 28) .................................. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19c. 20b 21. 22. 23. 24. 25. 26. 27. 28. 29. In Bankruptcy Round all entries 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Certification of Signatures and Authorization Section Under penalties of perjury, I declare I have examined this return, including all accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete. E-mail Address EE I authorize the Department to discuss my return with my personal representative (see page 7) Yes No Paid Preparer: Firm's Name (or yours if self-employed) Signature of Officer Print or Type Name of Officer Personal Representative's Name (Print or Type) Telephone Number Address City State ZIP Code + 4 Date Title PTIN Telephone Number Address City State ZIP Code + 4 Date Paid Preparer's Signature Please mail your return to: Indiana Department of Revenue, PO Box 7228
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