
DO NOT CUT OR STAPLE.
S&U: 2100
1/16
2100
DO NOT USE THIS SPACE
Balance of Tax
Disallowed Discount
Interest
Penalty
Total
PERIOD COVERED
DUE DATE
Account No.
Name
Address
TOTAL AMOUNT REMITTED
CHECK THIS BOX IF PAYMENT
MADE THROUGH ELECTRONIC
FUNDS TRANSFER (EFT)
$ .
Prepare / File / Pay this return online:
www.revenue.alabama.gov/salestax/efiling.html
COLUMN A COLUMN B COLUMN C COLUMN D COLUMN E
Farm/Mfg. 1.5% Auto. 2% Vend. Mach. 3% Consumable All Other 4%
Vapor Products 4%
1. Gross sales, amusements, and withdrawals ...........
2. Total Deductions ................................
3. Total amount remaining as
measure of tax (line 1 minus line 2) ..................
4. Gross Tax (line 3 x rate shown at column heading) ......
5. Automotive withdrawal fee (For Automobile Dealers Only) No. of Demos.
_______
withdrawn..................................................
6. TOTAL AMOUNT OF TAX (total line 4 cols. A, B, C, D, E and Line 5) ....................................................................
7. LESS: Discount – 5% on $100 or less in tax and 2% on tax over $100 (May not exceed $400.00) ...............................................
8. LESS: Estimate Paid on last month’s return .......................................................................................
9. PLUS: Estimate Due for current month...........................................................................................
10. TOTAL TAX DUE (line 6 minus lines 7 and 8 plus line 9)..............................................................................
11. PLUS: Penalty and interest, if due (see instructions).................................................................................
12. PLUS: Amounts overcollected .................................................................................................
13. LESS: Credit Claimed. Any credit for prior overpayment must be approved in advance by Department of Revenue...................................
14. TOTAL AMOUNT DUE (line 10 plus lines 11 and 12 minus line 13). Transfer to front of return. .................................................
Signed: ________________________________________________________________________ Date: _____________________________________________________________