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9A Worksheet for instructions. Name Account Number 10- Address Filing Period (Enter month or quarter and year) City, State, ZIP Code Due Date (20th of month following end of period) RETAIL SALES AND USE TAX A - SALES Rev. 04/23 B - AMOUNT DUE 1 Gross Sales and/or Rentals 1 2 Personal Use 2 3 Miscellaneous Exempt State Sales and Other Deductions. Do not include Food and Essential Personal Hygiene Products. See instructions. 3 4 Total Taxable Sales and Use. Line 1 plus Line 2.

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