Consumers Use Tax Return
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Consumers Use Tax Return Form. This is a Indiana form and can be use in Department Of Revenue Statewide.
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Tags: Consumers Use Tax Return, ST-115, Indiana Statewide, Department Of Revenue
Form ST-115
State Form 321
(R5/ 3-08)
Consumer’s Use Tax Return
Period beginning (month/year)
Quarterly
Monthly
and ending (month/year)
Name
Tax Computation
Street Address
City or Post Office, County, State, and Zip Code
Principal Business Activity
ID Type
(circle one)
Check Type of Return
Annual
Indiana Department of Revenue
Indiana TID #
Federal ID #
Social Security Number
ID Number
1. Total purchases subject to tax
(from reverse side)..................
2. Use Tax
(7% of Line 1)........................
3. Penalty (10% of Line 2) &
Interest (call the Department*)
if paid after due date...............
4. Total amount due
(add Lines 2 and 3 )................
,
,
,
$
,
,
$
,
,
,
.
.
.
.
For Departmental Use Only
Signature & Title if other than individual return
Date
I declare under the penalties of perjury that to the best of my knowledge and belief, this is a true, correct, and complete return.
*Call (317) 233-4015 or by e-mail at: www.in.gov/dor/contactus/email.html
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List all purchases of tangible personal property subject to use tax.
Name and Address of Seller
Description of Property Purchased
Purchase Price
of Property
Date of
Purchase
,
,
,
$
,
,
TOTAL*
,
,
After completing this form, mail with payment to:
Indiana Department of Revenue, 100 N. Senate Ave, Indianapolis, IN 46204
,
,
(if more space is needed, please attach a schedule)
,
,
$
,
,
,
.
.
.
.
.
.
.
*This amount goes on Line 1,
on the front of this form.
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