G-49 Instructions — Hawaii General Excise / Use Tax Annual Reconciliation

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Column a Column b Column c BUSINESS VALUES, GROSS PROCEEDS EXEMPTIONS/DEDUCTIONS TAXABLE INCOME ACTIVITIES OR GROSS INCOME (Attach Schedule GE) (Column a minus Column b) PART I - GENERAL EXCISE and USE TAXES @ ½ OF 1% (.005) 1. Wholesaling 1 2. Manufacturing 2 3. Producing 3 4. Wholesale Services 4 7. Sum of Part I, Column c (Taxable Income) - Enter the result here and on page 2, line 24, Column c 7 PART II - GENERAL EXCISE and USE TAXES @ 4% (.04) 8. Retailing 8 10. Contracting 10 12. Commissions 12 14. Other Rentals 14 17. Sum of Part II, Column c (Taxable Income) - Enter the result here and on page 2, line 25, Column c 17 5. Landed Value of Imports for Resale 6. Business Activities of Disabled Persons 9. Services Including Professional 11. Theater, Amusement and Broadcasting 13. Transient Accommodations Rentals 15. Interest and All Others 16. Landed Value of Imports for Consumption (REV. 2023) 16

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TAX YEAR ENDING HAWAII TAX I.D. NO. GE Last 4 digits of your FEIN or SSN NAME: ___________________________________

STATE OF HAWAII - DEPARTMENT OF TAXATION GENERAL EXCISE/USE

# ANNUAL RETURN & RECONCILIATION

• ATTACH CHECK OR MONEY ORDER HERE • DECLARATION - I declare, under the penalties set forth in section 231-36, HRS, that this return (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 return, made in good faith for the tax period stated, pursuant to the General Excise and Use Tax Laws, and the rules issued thereunder. IN THE CASE OF A CORPORATION OR PARTNERSHIP, THIS RETURN MUST BE SIGNED BY AN OFFICER, PARTNER OR MEMBER, OR DULY AUTHORIZED AGENT. G491H7V9 ID NO 01 G49_I 2023A 01 VID01 Fill in this oval ONLY if this is an AMENDED return (mm dd yy)

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Continued on page 2 - Parts V & VI MUST be completed Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00

Column a Column b Column c BUSINESS VALUES, GROSS PROCEEDS EXEMPTIONS/DEDUCTIONS TAXABLE INCOME ACTIVITIES OR GROSS INCOME (Attach Schedule GE) (Column a minus Column b) PART III - INSURANCE COMMISSIONS @ .15% (.0015) Enter this amount on line 26, Column c PART IV - COUNTY SURCHARGE - Enter the amounts from Part II, line 17, Column c attributable to each county. Multiply Column c by the applicable county rate(s) and enter the total of the result(s) on Part VI, line 27, Column e. 19. Oahu (rate = .005) 19 20. Maui (rate = .005) 20 21. Hawaii (rate = .005) 21 22. Kauai (rate = .005) 22 18. Insurance Commissions

# PART VI - TOTAL RETURN AND RECONCILIATION TAXABLE INCOME TAX RATE TOTAL TAX

Column c Column d Column e = Column c X Column d 24. Enter the amount from Part I, line 7 ................... x .005 24. 25. Enter the amount from Part II, line 17 ................ x .04 25. 26. Enter the amount from Part III line 18, Column c ............. x .0015 26. 27. COUNTY SURCHARGE TAX. See Instructions for Part IV. Multi district complete Form G-75 ....27. 28. TOTAL TAXES DUE. Add column e of lines 24 through 27 and enter result here (but not less than zero). If you did not have any activity for the period, enter "0.00" here ..............................................28. 29. Amounts Assessed During the Period....................... PENALTY $ INTEREST $ 29. 30. TOTAL AMOUNT. Add lines 28 and 29. ...................................................................................30. 31. TOTAL PAYMENTS MADE LESS ANY REFUNDS RECEIVED FOR THE TAX YEAR ..................31. 32. CREDIT CLAIMED ON ORIGINAL ANNUAL RETURN. (For Amended Return ONLY) ...................32. 33. NET PAYMENTS MADE. Line 31 minus line 32 ..............................................................................33. 34. CREDIT TO BE REFUNDED. Line 33 minus line 30 ......................................................................34. 35. ADDITIONAL TAXES DUE. Line 30 minus line 33 .........................................................................35. 36. FOR LATE FILING ONLY  PENALTY $ INTEREST $ 36. 37. TOTAL AMOUNT DUE AND PAYABLE (Add lines 35 and 36) .......................................................37. 38. PLEASE ENTER THE AMOUNT OF YOUR PAYMENT. If you are NOT submitting a payment with this return, please enter "0.00" here. .........................................................................38. 39. GRAND TOTAL OF EXEMPTIONS/DEDUCTIONS CLAIMED. (Attach Schedule GE) If Schedule GE is not attached, exemptions/deductions claimed will be disallowed. ..........................................39. (REV. 2023) 16 Name:___________________________________________________ Hawaii Tax I.D. No. GE Last 4 digits of your FEIN or SSN TAX YEAR ENDING G492H7V9 .00 .00 ID NO 01 G49_I 2023A 02 VID01 (mm dd yy) Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg PART V - SCHEDULE OF ASSIGNMENT OF TAXES BY DISTRICT (ALL taxpayers MUST complete this Part and may be subject to a 10% penalty for noncompliance.) DARKEN the oval of the taxation district in which you have conducted business. IF you did business in MORE THAN ONE district, darken the oval "MULTI" and attach Form G-75. 23. Oahu Maui Hawaii Kauai MULTI

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