Washington Department of Revenue Forms & Publications

WA DOR dairy-fruitveg-seafood — Dairy, Fresh Fruit/Vegetable & Seafood Manufacturers Addendum

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(6/26/19) Dairy, Fresh Fruit/Vegetable, and Seafood Manufacturers Addendum Use Black Ink and Attach this Original Addendum to Your Return.4 Name: Account ID Manufacturing of Dairy Products [421] Manufacturing of Fresh Fruit/Vegetable Products [425] Manufacturing of Seafood Products [427] 1. 2. 3. 4. Gross Amount Gross Amount Gross Amount Deductions Total Deductions Total Deductions Total Taxable Amount Taxable Amount Taxable Amount Rate Rate Rate Tax Due Tax Due Tax Due , , , , , , , , , , , , , , , , , , , , . . . . . . . . . . . . . - - - = = = X .00484 X .00484 X .00484 4 Use this form to report only income related to dairy , fresh fruit/vegetable, and seafood manufacturing. All other income should be reported on the Combined Excise T ax Return. Reminder: Attach this addendum to your original return and mail to the Department. 4 Total Tax Amount Due Add all Addendum totals and transfer the amount to the Total All Addendums line of your tax return. For tax assistance or to request this document in an alternate format, please call 360-705-6705. Teletype (TTY) users may use the Washington Relay Service by calling 711. REV 41 0119 Year Period Business & Occupation (B&O) Tax Deductions taken but not itemized on the Deduction Detail will be disallowed.4 Amount 1. Manufacturing of Dairy Products [421] AmountI.D. , .Exempt Manufactured Products [42178] 2. Manufacturing of Fresh Fruit/Vegetable Products [425] AmountI.D. , . Exempt Manufactured Products [42578] Deduction Detail 3. Manufacturing of Seafood Products [427] AmountI.D. , .Exempt Manufactured Products [42778] Transfer the total deduction amount for each classification to the corresponding line(s) above under Business & Occupation (B&O) Tax.

(6/26/19) Fresh Fruit/Vegetable Manufacturers Deduction Detail 2. Wholesaling Fruit/Vegetable Out of State [XXX] AmountI.D. , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . . . . . . . . . . . . . . . . Bad Debts Cash & Trade Discounts Cash & Trade Discounts Freight on Out-of-State Deliveries Advances Reimbursement; Returns & Allowances Returns & Allowances [xxxx] [xxxx] [xxxx] [xxxx] [xxxx] [xxxx] Other (Explain below): Other (Explain below): [xxxx] [xxxx] Total Total , , , , , , , , , , , , , , , , . . . . . . . . Cash & Trade Discounts Cash & Trade Discounts Returns & Allowances Returns & Allowances [0302] [0102] [0307] [0131] Other (Explain below): Other (Explain below): [0399] [0199] Total Total REV 41 0119 Manufacturing of Fresh Fruits/Vegetable B&O Tax Due1. Wholesaling of Fresh Fruits/Vegetable for Transportation Outside WA B&O Tax Due2. Wholesaling B&O Tax Due (Manufactured Fruits/Vegetable Only)3. Retailing B&O Tax Due (Manufactured Fruits/Vegetable Only)4. Total Lines 2-45. Total MATC Allowed (Lesser of Line 1 OR Total 2-4) 6. Multiple Activites Tax Credit (MATC) Amount

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