Form G-49 Fillable Annual Return & Reconciliation of General Excise / Use Tax Return (Rev. 2008)
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

ATTACH CHECK OR MONEY ORDER HERE $ 00 x 0015 = $ $ 00 x 005 = $ $ 00 x 04 = $ (: 0) Unchecked (: 1) Unchecked (: 2) Unchecked (: 3) Unchecked (: 4) Unchecked (Attach Schedule GE) If Schedule GE is not attached exemptions/deductions (Rev 2008) (Rev 2008) 16 (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 01 (text) ID NO (text) t (text) t (text) t 10 Contracting 11 Theater Amusement 12 Commissions 13 Transient 14 Other Rentals 15 Interest and 16 Use Tax on Imports 17 Sum of Part II Column c (Taxable Income) Enter the result here and on Page 2 line 22 Column (a) 19 Oahu Surcharge 21 Enter the amount from Part I line 7 22 Enter the amount from Part II line 17 23 Enter the amount from Part III line 18 Column c 24 Enter the amount from Part IV line 19 Column c 7 Sum of Part I Column c (Taxable Income) Enter the result here and on Page 2 line 21 Column (a) Accommodations Rentals ACTIVITIES OR GROSS INCOME (Attach Schedule GE) (Column a minus Column b) ADDITIONAL TAXES DUE Line 27 minus line 30 32 All Others Amounts Assessed on Periodic Returns and Broadcasting ANNUAL RETURN & be completed be subject to a 10% penalty for noncompliance ) See Instructions DARKEN the oval of the taxation district in which you Business Activities of BUSINESS VALUES GROSS PROCEEDS EXEMPTIONS/DEDUCTIONS TAXABLE INCOME claimed will be disallowed 36 Column (a) Column (b) Column (c) = Column (a) X Column (b) Column a Column b Column c Commissions Continued on Page 2 Parts V & VI MUST CREDIT CLAIMED ON ORIGINAL ANNUAL RETURN (For Amended Return ONLY) 29 CREDIT TO BE REFUNDED Line 30 minus line 27 31 DECLARATION I declare under the penalties set forth in section 231 36 HRS that this return (including any accompanying schedules or statements) has been did not have any activity for the period enter 0 00 here 25 Disabled Persons DO NOT WRITE IN THIS AREA Enter this amount on line 23 Column (a) Enter this amount on line 24 Column (a) examined by me and to the best of my knowledge and belief is a true correct and complete return made in good faith for the tax period stated pursuant to the Fill in this oval ONLY if this is an AMENDED return For Consumption FOR LATE FILING ONLY Form G 49 FORM G 49 FORM G 49 Page 2 of 2 FILL FORM G 49 Page 2 of 2 FILL GCF081 GCF082 General Excise and Use Tax Laws and the rules issued thereunder GENERAL EXCISE/USE GRAND TOTAL OF EXEMPTIONS/DEDUCTIONS CLAIMED have conducted business IF you did business in MORE THAN ONE district darken the oval MULTI and attach Form Hawaii Hawaii Tax I D No W HONOLULU HI 96806 1425 or file and pay electronically at www ehawaii gov/efile I D No on your check or money order Mail to: HAWAII DEPARTMENT OF TAXATION P O BOX 1425 If you are NOT submitting a payment with this return please enter 0 00 here 35 Imports For Resale IN THE CASE OF A CORPORATION OR PARTNERSHIP THIS RETURN MUST BE SIGNED BY AN OFFICER PARTNER OR MEMBER OR DULY AUTHORIZED AGENT Insurance INTEREST $ Kauai Last 4 digits of your FEIN or SSN Manufacturing MULTI Name: NET PAYMENTS MADE Line 28 minus line 29 30 PART I GENERAL EXCISE and USE TAXES @ OF 1% ( 005) PART II GENERAL EXCISE and USE TAXES @ 4% ( 04) PART III INSURANCE COMMISSIONS @ 15% ( 0015) PART IV CITY & COUNTY OF HONOLULU SURCHARGE TAX @ OF 1% ( 005) PART V SCHEDULE OF ASSIGNMENT OF TAXES BY DISTRICT (ALL taxpayers MUST complete this Part and may PART VI TOTAL RETURN AND RECONCILIATION PENALTY $ PLEASE ENTER THE AMOUNT OF YOUR PAYMENT Attach a check or money order payable Producing Professional RECONCILIATION Retailing Services Including SIGNATURE TITLE DATE STATE OF HAWAII DEPARTMENT OF TAXATION Tax Year Ending TAXABLE INCOME TAX RATE TOTAL TAX to HAWAII STATE TAX COLLECTOR in U S dollars to Form G 49 Write GE the filing period and your Hawaii Tax TOTAL AMOUNT Add lines 25 and 26 27 TOTAL AMOUNT DUE AND PAYABLE (Add lines 32 and 33) 34 TOTAL PAYMENTS MADE LESS ANY REFUNDS RECEIVED FOR THE TAX YEAR 28 TOTAL TAXES DUE Add column (c) of lines 21 through 24 and enter result here If you Use Tax on Wholesale Services Wholesaling