2010 Annual Statement of Gross Receipts
From May 1, 2009 Through April 30, 2010
Ohio Department of Taxation
Public Utility Tax Section
P. O. Box 530
Columbus, Ohio 43216 - 0530
The Public Utility Tax Section is located at 30 East Broad Street, 19th Floor, Columbus, Ohio 43215
Telephone (614) 466-7371 Fax (614) 752-2496
Public Utility Information
Name: Utility Class: Water-Works Company
City: Due Date State of Inc.
State: This statement and Date of Inc.
Zip: schedules are due Ohio Charter #
on or before
Contact: August 1, 2010 For Department Use Only Initial
If additional time is Date Received
Phone: needed you may Audit Completed
apply for an Audit Reviewed
Fax: extension of up to Assessment
Gross Receipts Tax Calculation
1 OHIO TAXABLE GROSS RECEIPTS (Page 3, line 26, Column I) 1
2 LESS 25,000 DEDUCTION (25,000) 2
3 TAXABLE GROSS RECEIPTS (line 1 less line 2) 3
4 TAX RATE 4.75% 4
5 TOTAL TAX (line 3 x line 4) Minimum Tax is $ 50.00 5
Tax Payments Date Amount
6 OCTOBER PAYMENT 6
7 MARCH PAYMENT 7
8 JUNE PAYMENT 8
9 TOTAL of lines 6 through 8 9
Refund or Amount Owed
IF LINE 9 IS GREATER THAN LINE 5, Subtract line 5 from line 9
and enter AMOUNT TO BE REFUNDED
IF LINE 9 IS LESS THAN LINE 5, Subtract line 9 from line 5 and enter AMOUNT OWED
The Treasurer of State will bill you. Do not send payment at this time.
I declare under penalties of perjury that this report, including any accompanying schedules or statements, has been examined by me and to the best of my knowledge and belief is a
true, correct and complete report. This public utility has not, during the preceding year, except as permitted by sections 3517.082, 3599.03, and 3599.031 of the Revised Code,
directly or indirectly used any of its money or property for or in aid of or opposition to a political party, a candidate for election or nomination to a public office, or a political action
committee, legislative campaign fund, or organization that supports or opposes any such candidate or in any manner used any of its money or property for any partisan political
purpose whatever, or for the reimbursement or indemnification of any person for money or property so used.
Date Signature Title
WATER-WORKS COMPANY & NON UTILITY ACTIVITIES - GROSS RECEIPTS
L (A) (B) (C)
I TOTAL OHIO
SOURCE OF GROSS RECEIPTS TOTAL GROSS INTERSTATE BUSINESS DONE
E RECEIPTS BUSINESS IN OTHER STATES
4 OTHER SALES TO PUBLIC AUTHORITIES
7 CONTRACT WORK
8 SEWAGE DISPOSAL
11 FORFEITED DISCOUNTS
13 NON UTILITY OPERATIONS
14 NON UTILITY RENTAL
15 NON UTILITY MERCHANDISE
16 NON UTILITY MISCELLANEOUS
See instructions for information on how to complete this schedule and columns for which additional detail must be provided.
FROM MAY 1, 2009 THROUGH APRIL 30, 2010
Round all amounts to the nearest dollar.
(G) (H) (I) L
BUSINESS DONE FOR SALES TO OTHER I
SALE OF TOTAL INTRASTATE OHIO TAXABLE N
OR WITH FEDERAL PUBLIC UTILITIES
MERCHANDISE DEDUCTIONS GROSS RECEIPTS E
INSTRUCTIONS FOR COMPLETING PAGES 2 AND 3
WATER-WORKS COMPANY ANNUAL STATEMENT OF GROSS RECEIPTS
Please note that this statement is to be used to report all water-works activities gross receipts (activities of supplying to customers via pipes or
tubing) and all other activities (nonutility). The gross receipts should be reported on what you actually received, i.e. cash or equivalent, for the
period May 1, 2009 through April 30, 2010. Amounts should be rounded to the nearest dollar.
If you have a source of gross receipts that is not listed on the statement, you must list those receipts in the blank spaces provided. If
you need additional space you may attach a supplemental schedule. Whether taxable or not, all business gross receipts must be listed on this
Explanation of the Columns of the Report.
(A) Total Gross Receipts: Enter the total gross receipts for all business done, including nonutility activities.
(B) Interstate Business: Enter all gross receipts derived wholly from interstate business. IF OVER $10,000, ATTACH A BREAKDOWN
LISTING EACH ENTITY AND THE AMOUNT PER ENTITY THAT AN EXEMPTION IS CLAIMED.
(C) Business Done in Other States: Enter all gross receipts from intrastate business provided entirely in a state other than Ohio. IF OVER
$10,000, ATTACH A BREAKDOWN LISTING THE STATES AND THE AMOUNT PER STATE THAT AN EXEMPTION IS CLAIMED.
(D) Total Ohio Intrastate Receipts: Subtract Columns B and C from Column A - Only business done in Ohio should be claimed on the columns
(E) Business Done For or With the Federal Government: Enter all gross receipts for business done in Ohio for or with the federal government.
Federal government does not include state and local agencies such as the Ohio National Guard, schools, colleges, and non-federal organizations
wholly or partially funded by the federal government. IF OVER $10,000, ATTACH A BREAKDOWN LISTING EACH FEDERAL AGENCY AND
THE AMOUNT PER AGENCY THAT AN EXEMPTION IS CLAIMED.
(F) Sales to Other Public Utilities for Resale: Enter all gross receipts from sales to other public utilities in Ohio (taxable as public utilities under
Chapter 5727 of the Revised Code) for resale, excluding telephone companies, railroads, electrics, rural electrics and interexchange
telecommunications companies. Do not include a public utility located in or outside of Ohio that is not subject to the gross receipts excise tax
(5727.24 or 5727.30 R.C.) under this column. If exempt, sales located outside of Ohio should be reported under Column B. IF OVER $10,000,
ATTACH A BREAKDOWN LISTING EACH PUBLIC UTILITY AND THE AMOUNT PER PUBLIC UTILITY THAT AN EXEMPTION IS CLAIMED.
(G) Sale of Merchandise: Enter all gross receipts from the sale of merchandise in Ohio. Merchandise includes items of tangible personal
property such as equipment, appliances, and also includes food and beverages, that is sold in the ordinary course of business. It does not include
the sale of services or the gross receipts derived from the rental or lease of property. Items subject to Ohio's sales tax do not automatically come
within this deduction. YOU MAY BE ASKED TO PROVIDE ADDITIONAL DETAIL ON THE MERCHANDISE CLAIMED AS AN EXEMPTION.
(H) Total Intrastate Deductions: Add Columns E, F and G.
(I) Ohio Taxable Gross Receipts: Subtract Column H from Column D.
The total on line 26, Column I, (Ohio Taxable Gross Receipts) should be entered in the tax calculation portion of this statement.
If you have questions?
Please contact the Public Utility Tax Section at (614) 466-7371 or Fax (614) 752-2496.
This statement and all accompanying schedules should be sent to:
Address for U.S. Postal Service: Address for other delivery services:
Ohio Department of Taxation Ohio Department of Taxation
Public Utility Tax Section Public Utility Tax Section
P.O. Box 530 30 East Broad Street, 19th Floor
Columbus, OH 43216-0530 Columbus, OH 43215