Business Deduction Gas Receipts - Excel

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					                                                                                    3rd Quarter 2010

                                          Natural Gas Excise Tax Quarterly Statement
                                                     From July 1, 2010 Through September 30, 2010
                                                             Ohio Department of Taxation
                                                                           Public Utility Tax Section
                                                                                P. O. Box 530
                                                                         Columbus, Ohio 43216 - 0530

     Send completed statement to the Tax Commissioner. Payment must be made to the Treasurer of State by electronic funds transfer.

                    Telephone (614) 466-7371                                                                                            Fax (614) 752-2496
                                                                                                                                    Fax (614) 752-2496
                         Public Utility Information

Name:                                                                                                          FEIN:
Address:
                                                                                                               State of Inc.


City:                                                                                 Due Date                 Date of Inc.
State:                                                                            This statement and Ohio Charter #
Zip:                                                                              payment are due on Entity Type:
                                                                                       or before

Contact:                                                                           November 14, 2010                For Department Use Only                                                 Initial
                                                                                                      Date Received TOS
Phone:                                                                             Payment must be Date Received DOT
Fax:                                                                               made by electronic Audit Completed
Email:                                                                               funds transfer   Audit Reviewed
                                                                                                      Assessment
                         Gross Receipts Tax Calculation
                    1                                                                                                                                                                         1
                         OHIO TAXABLE GROSS RECEIPTS (Line 26, Column J)
Tax Calculation




                    2                                                                                                                                                                         2
                         LESS 6,250 DEDUCTION                    (Not applicable to a combined company)                                                                      (6,250)
                    3                                                                                                                                                                         3
                         TAXABLE GROSS RECEIPTS (Line 1 less Line 2)
                    4                                                                                                                                                                         4
                         TAX RATE                                                                                                                                              4.75%
                    5                                                                                                                                                                         5
                         TAX OWED BEFORE CREDIT (Line 3 x Line 4)
                         Calculation of Refundable Credit
                    6 Enter amount paid OCTOBER 15, 1999                                                                                                                                      6
                    7 Enter amount paid MARCH 1, 2000                                                                                                                                         7
Credit




                   8 Enter amount paid JUNE 1, 2000                                                                                                                                           8
                   9 Enter amount paid JUNE 30, 2001 Per Section 175 Am. Sub. H.B. No. 283                                                                                                    9
                   10 TOTAL of lines 6 through 9                                                                                                                                              10
                   11 Divide TOTAL (line 10) by 60 and enter AMOUNT OF REFUNDABLE CREDIT                                                                                                      11
                         Amount Owed
Tax




                   12                                                                                                                                                                         12
                         Subtract line 11 from line 5 and enter AMOUNT OWED

   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
                                                                                            Page 1
                  NATURAL GAS & NON UTILITY ACTIVITIES               -   GROSS RECEIPTS

COMPANY NAME:                                                                       FEIN:

 L                                                                                              (D)
                                               (A)              (B)              (C)
 I                                                                                          TOTAL OHIO
 N     SOURCE OF GROSS RECEIPTS           TOTAL GROSS       INTERSTATE     BUSINESS DONE
                                                                                            INTRASTATE
 E                                          RECEIPTS         BUSINESS     IN OTHER STATES
                                                                                             RECEIPTS


 1   RESIDENTIAL

 2   COMMERCIAL

 3   INDUSTRIAL

 4   OTHER SALES TO PUBLIC AUTHORITIES

 5   GAS SALES FOR RESALE

 6   GAS BILLED FOR OTHERS

 7   TRANSMISSION OF GAS - GATHERING

 8   TRANSMISSION OF GAS - DISTRIBUTION

 9   TRANSMISSION OF GAS - TRANSMISSION

10   STORING GAS OF OTHERS

11   RENTS

12   PLANT LEASED TO OTHERS

13   SALES OF PRODUCTS EXTRACTED - GAS

14   NATURAL GAS PROCESSED BY OTHERS

15   INCIDENTAL GASOLINE & OIL SALES

16   OTHER OPERATING RECEIPTS

17   MERCH., JOBBING & CONTRACT WORK

18   MISCELLANEOUS SERVICE

19   FORFEITED DISCOUNTS

20   NON UTILITY OPERATIONS

21   NON UTILITY RENTAL

22   NON UTILITY MERCHANDISE

23   NON UTILITY MISCELLANEOUS

24

25

26 TOTAL



                                                   Page 2
                 FROM JULY 1, 2010 THROUGH SEPTEMBER 30, 2010
                                    Round all amounts to the nearest dollar.
COMPANY NAME:                                                                          FEIN:
       (E)
                       (F)                                                          (I)                         L
 BUSINESS DONE                            (G)                  (H)                                   (J)
                 SALES TO OTHER                                                   TOTAL                         I
  FOR OR WITH                           SALE OF          GAS BILLED FOR                         OHIO TAXABLE    N
                 PUBLIC UTILITIES                                              INTRASTATE
    FEDERAL                           MERCHANDISE           OTHERS                             GROSS RECEIPTS   E
                   FOR RESALE                                                  DEDUCTIONS
  GOVERNMENT

                                                                                                                1

                                                                                                                2

                                                                                                                3

                                                                                                                4

                                                                                                                5

                                                                                                                6

                                                                                                                7

                                                                                                                8

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                                                                                                                14

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                                                                                                                22

                                                                                                                23

                                                                                                                24

                                                                                                                25

                                                                                                                26



                                                       Page 3
                                              INSTRUCTIONS FOR COMPLETING
                                       NATURAL GAS EXCISE TAX QUARTERLY STATEMENT

Please note that this statement is to be used to report all natural gas activities gross receipts (activities of supplying natural gas to consumers for lighting,
power, or heating purposes) and all other activities (nonutility). The gross receipts should be reported on what you actually received, i.e. cash or equivalent,
for the period July 1, 2010 through September 30, 2010. Amounts should be rounded to the nearest dollar.


If you have a source of gross receipts that are 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 schedule.

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 below.

(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) Gas Billed for Others: Enter all gross receipts from gas billed on behalf of other entities in Ohio, excluding transportation and other billing and collection
fees charged to other entities. IF OVER $10,000, ATTACH A BREAKDOWN LISTING EACH ENTITY AND THE AMOUNT PER ENTITY THAT AN
EXEMPTION IS CLAIMED.

(I) Total Intrastate Deductions: Add Columns E, F, G and H.

(J) Ohio Taxable Gross Receipts: Subtract Column I from Column D.

The total on Line 26, Column J, (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:                   Questions about Electronic Funds Transfer:
           Department of Taxation                  Department of Taxation                                 Treasurer of State
           Public Utility Tax Section              Public Utility Tax Section                             Attn: Kelly Alvis
           PO Box 530                              30 East Broad Street, 19th Floor                       30 East Broad Street, 9th Floor
           Columbus, OH 43216-0530                 Columbus, OH 43215                                     Columbus, OH 43215

                                                                                                          (614) 752-8482


                                                                            Page 4

				
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