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STW 3300101 A: Taxpayer FEIN/SSN B: Reporting Period C: Due Date 1. Total number of tires sold 2. Total number of tires exempt 3. Passenger tire fees ($1.00 per tire) 4. Truck tire fees ($3.50 per tire) 5. Less 2.25% for timely filing 6. Interest 7. Penalty 8. Total Due + + - + + = D: Change E: Out of Business Use this worksheet for figuring your tax, then enter the figures on the report below. Instructions for Completing the Oklahoma Waste Tire Report General Instructions... • Please write only in the white areas. • If any preprinted information on this report is incorrect or your business address has changed, place an “X” in item D and enter the correct information on back of the form in the space provided. • Please use a #2 pencil or pen with black ink to mark your entries on this form. Use the alignment box immediately after “Number of tires sold” (Line 1) to align your typewriter for typing the numbers in the handprint boxes. Specific Instructions... • If you no longer sell tires and/or are out of business, place an “X” in item E below. • If you are out of business, you must return your Sales Tax Permit to the Oklahoma Tax Commission. Line 1 Enter the total number of tires sold. Line 2 Enter the total number of tires that are exempt from the fee. No fee shall be assessed by a tire dealer for used or retreaded tires when the tire dealer can document that the recycling fee has been previously paid. Line 3 Enter the total amount of tire fees collected. ($1.00 per tire with a tire rim diameter of 17 1 /2 inches or less or motorcycle, etc. tires) Line 4 Enter the total amount of tire fees collected. ($3.50 per tire with a tire rim diameter of greater than 17 1 /2 inches) Line 5 If this report and remittance is postmarked by the due date shown in item C, you are eligible for a 2.25% discount for timely payment. Add the amount on line 3 and line 4 together and multiply by .0225. Line 6 (interest) If this tax report and remittance is postmarked after the due date shown on item C, the tax is subject to 1.25% interest per month from the due date (item C) until it is paid. Add the amount on line 3 and line 4 together and multiply by .0125 for each month or part thereof that the report is late. Line 7 (penalty) If this tax report and remittance is not postmarked within 15 days of the due date, a one-time 10% penalty is due. Line 8 (total due) Total the report; line 3 plus line 4, minus line 5, plus line 6 and line 7. To ensure proper processing, please print all figures within boxes as shown here. Please detach here and return report below 1. Total number of tires sold 2. Total number of tires exempt 3. Passenger tire fees ($1.00 per tire) 4. Truck tire fees ($3.50 per tire) 5. Less 2.25% for timely filing 6. Interest 7. Penalty 8. Total Due - - - - - - dollars - - - - - - cents + + - + + = Oklahoma Waste Tire Report STW 3300101 F. 000 A: Taxpayer FEIN/SSN B: Reporting Period C: Due Date Office Use Only F.C. P.T. D: Change E: Out of Business MMDD I declare that the information contained in this document and any attachments is true and correct to the best of my knowledge and belief. Sign here Date 0 0 0 0 - - - - - - dollars - - - - - - cents Oklahoma Waste Tire Report Taxpayer Copy/Worksheet STW0001-05-2001-BT BT-119 Revised 6-2005 Name • Address • City • State • Zip
