ANNUAL Business and Occupation Tax Report

License Number*

Enter your City of Lacey Business License number.

Period*

Enter the year you are reporting.

Do you need to update your mailing address?*

If yes, enter your address in the section below.

New Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is this business still operating in Lacey?*

If no, please enter the date the business closed below.

Business Closure Date

MonthDayYear

Yes, my business qualifies for this exemption.

IF YOUR TOTAL TAXABLE INCOME FOR THE YEAR IS LESS THAN $20,000,
NO TAX IS DUE.

YOUR REPORT MUST STILL BE FILED.

Tax Report - Enter your income data in this section and the totals will appear below. Tax rates are as follows: Retailing, 0.001 Contractor, 0.001 Printing/Publishing, 0.001 Service & Other Activity, 0.002*

Rows	Gross Amount	Deductions (If reporting this column, select yes for Show Deductions Worksheet below)	Taxable Gross Amount	Tax Amount Due	Penalties	Total Tax and Penalties Due
Retailing
Contractor
Printing/Publishing
Service & Other Activity

Total Taxable Amount

Calculated from the table above

Statement Total (Tax Amount Due)

Calculated from the table above

Penalties (If Applicable)

Calculated from the table above

Previous Balance (If Applicable)

Enter if applicable

TOTAL AMOUNT DUE

Calculated from entries above

Form Calculations

Show Deductions Worksheet

Select Yes to display the Deductions Worksheet

Deductions Worksheet

Rows	Retailing	Contractor	Printing/Publishing	Service & Other Activity
Bad Debts
Cash & Trade Discounts
Motor Vehicle Fuel Sale
Liquor Sales
Total Business Tax Deductions

Contact Information*

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email*

example@example.com

Date of submission*

MonthDayYear

Yes, I agree with this statement.

ANNUAL Business and Occupation Tax Report - NO PAYMENT ONLY