Indiana Department of Revenue. Sales Tax Vouchers and/or Electronic Funds Transfer Credit Recap

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1 Form ST-103 Revised 8/00 Account Number xxxxxxxxxx xxx x Indiana Department of Revenue Sales Tax Vouchers and/or Electronic Funds Transfer Credit Recap Filing Status XXXXXXXXXXXXXXXXXXXXX 2001 The current annual interest rate for late payments is %. This packet contains sales tax vouchers for payments by check or EFT recap report(s) for those who remit electronically. Also included is a Change Form to report any changes and a record keeping form. Your sales tax vouchers are due on the date printed on your vouchers. Electronic funds transfer credit recap reports are due on the 20th or the 30th day of the month following the close of the quarter depending on your filing frequency. Make sure the information on this page is correct and complete. Report any error or change on the Change Form. For assistance call (317) or you may the Department at:

2 Account Number xxxxxxxxxx xxx x New Location Address DBA Name Address City Change Form Mail to the Indiana Department of Revenue PO Box 6197 Indianapolis IN New Mailing Address Name Address City State Zip Code State Zip Code Federal ID# Telephone Number S! ( ) Please check here if your business has been permanently closed and give the close date. County Month Day Year Federal ID# Telephone Number ( ) County If this account is out of business indicate the reason below. Signature Title Date

3 Month January February March April May June July August September October November December For your records only. Do not send to the Indiana Department of Revenue. Amount of Amount of Tax Tax Date Paid Due Paid Check Number

4 Enter Total Exempt Purchases...J. Total Taxable Purchases (Subtract Line J from Line I)...K. Use Tax Due (5% of Line K)...L. If Late Penalty is Greater of (10%) of Lines F & L or $5 (Plus interest)...m. Electronic Funds Transfer Credit...N. Adjustments (see instructions) An explanation must be attached...o. Total Amount Due (Add Lines H L & M Plus or Minus Line N & O)...P. Pay this amount. Sales and Use Tax Template for Form ST-103 $ Cut Here Instructions for the Sales and Use Tax Template for Form ST-103 Cut the Template where it says to Cut Here. Align the Letters for the wording to correspond with the line. The right edge will align with the form. You will receive only one per packet of forms.

5 Enter Total Sales for Period (Do Not Include Sales Tax).. A. Enter Total Exempt Sales... B. Total Taxable Sales (Subtract Line B from Line A)... C. Sales Tax Due (5% of Line C)... D. Tire Fee Due (.25 Per New Tire Sold at Retail)... E. Total of Lines D and E... F. Instructions for the Sales and Use Tax Template for Form ST-103 Cut the Template where it says to Cut Here. Align the Letters for the wording to correspond with the line. The right edge will align with the form. You will receive only one per packet of forms. Collection Allowance (1% of Line F) *... G. Net Amount Due (Subtract Line G from Line F)... H. Enter Total Purchases... I. * Do not use this line if payment is late. Sales and Use Tax Template for Form ST-103 Cut Here

6 Form ST-103 Indiana Sales And Use Tax Voucher A. SF44469 Revised 8/00 If you have address changes name corrections or business closing use the Change Form found in this packet. XXXXXBusiness NameXXXXX XXXXXXXDBA NameXXXXX Date Phone #( ) S Account Number For Tax Period XXXXXXXXXX XXX X XXX XXX XXX XXXX Filing Status Due on or Before XXXXXXXXX XX XX XXXX!!!!!!!!!!!!!!!!!!!!!!! INDIANA DEPARTMENT OF REVENUE P.O. BOX 7218 INDIANAPOLIS IN B. C. D. E. F. G. H. I J. K. L. M. N. O. P. $ Do not use the space above Pay this amount. Do not send cash. Make check payable to the Indiana Department of Revenue.. X Authorized Signature I declare under penalties of perjury that this is a true correct and complete voucher. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

7 Make checks payable to the Indiana Department of Revenue. Do not send cash. A voucher must be filed by the taxpayer even when no tax is due unless the account has been closed. If not an estimated return will be filed by the Department based on the best information available. A 20% penalty will be added to the estimated amount of tax due. Exception: Taxpayers filing by EDI do not submit paper returns. If the due date printed on your voucher falls on a weekend or legal holiday the voucher is due on the next business day. Your filing status is determined by Indiana law and is in effect for the entire tax year. It can be changed upon request only if you wish to file more frequently. If the account number listed on your vouchers is not your correct taxpayer identification number or if further instructions are needed call the Taxpayer Services Division at (317) Note: EFT taxpayers: Remitting by EFT does not change your filing frequency. Your tax payment due dates remain the same. However rather than file a coupon/voucher each month you file a quarterly recap form. The U.S. Postal Service postmark date determines if a return is timely. Please be aware of your local postal service's hours of mail pickup. A voucher filed after the due date is subject to a 10% penalty plus interest. Please do not write in this space.

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