THIS RETURN MUST BE FILED EVEN THOUGH NO TAX IS DUE CITY OF 
                       LAVA HOT SPRINGS  
                  NON PROPERTY TAX UNDER ORDINANCE NO 2015-11  
                       DUE ON OR BEFORE 25TH OF EACH MONTH 

                                                       1.  TOTAL retail sales   . . . . . . . . . . . . . .    $ _________________________________      

 REPORTING PERIOD: ______________________________      2. Less Exempt Retail Sales . . . . . . . .    $ _________________________________              
 (Required)                                            3.  TOTAL taxable retail sales  . . . . .    $ _________________________________      
 Business Name:  ____________________________________  (Subtract line 2 from line 1)       
                                                        
 (Required)                                                       4.  Tax Due for Period for Retail     . . . . .                 $ ____________________           
                                                                  (Multiply line 3 x 2%)   
 Contact Number:  _________________________________     
 (Required)                                            5.   Sales from Liquor-By-Drink . . . . . . . .   $ _____________________________ 
 Permit No:  _________________________________________            6.  Tax Due for Period for Liquor by the Drink … $ ____________________           
                                                                  (Multiply line 5 x 2%)   
 (Required)                                             
 Email Address:  ___________________________________   7.  Sales from Rents      . .. . . . . . . . . . . .. . .    $ ______________________________         
 Mailing Address:  _________________________________   8. Less Nontaxable Rents . ... . . . . ... .. . .    $ _______________________________                       
                                                       9.   TOTAL taxable Rents  . . . . . . . . ... . . . . . .   $ _______________________________       
                  _________________________________    (Subtract line 8 from line 7)   
                                                                  10.  Tax Due for Period for Rents   . . . . .               $ ____________________     
                                                                  (Multiply Line 9 x 3%)    
                  _________________________________     
                                                       11.  TOTAL TAX DUE FOR PERIOD  . .                           . . . .  . $ ______________________________                                     
                                                       (Add line 4, 6 & 10) 
                                                        
 Report any Changes:                                   12.  After Due Date    . . . . . . . . . . . . . .   . . . . . . . . .   $ _____________________________                                    
                                                       Add 18% per Annum interest    _ 
 ________________________________________________
                                                        
 ________________________________________________
                                                       PAYMENT ENCLOSED  . . . . . . . . . . . . . . . . . .   $ ______________________________                                     
 ________________________________________________
 ________________________________________________
 ________________________________________________
 ________________________________________________ 

        I/We the undersigned do hereby swear or affirm that the above information is due and correct to the best of my/our knowledge. 
                                                             
DATE ___________________    AUTHORIZED SIGNATURE__________________________________________               TITLE__________________________ 
 
  Attach a copy of the Idaho Sales Tax Return for the Reporting Period.  
                       Mail to City Clerk, P.O. Box 187, Lava Hot Springs, Idaho 83246 
 ____________________________________________________________________________________________________________________________________ 
                       MAKE A COPY FOR YOUR RECORDS - SEND THIS COPY WITH YOUR REMITTANCE