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Town of Monument Carry out Bag Fee Return Instructions The returns and checks should be mailed to: Town of Monument – Sales Tax 645 Beacon Lite Rd Monument, CO 80132 Per Colorado House Bill HB21-1162, beginning January 01, 2023, businesses meeting the criteria outlined in the bill will be required to collect $0.10 per recycled paper carryout bag or single-use plastic carryout bag provided to a customer at the point of sale. Of this fee, $0.06 per bag must be remitted to the Town of Monument on a quarterly basis. Starting after the first quarter 2024 the Bag Fee Report is due on the 20th of the month following the quarter end. The gap between the fee start date of Jan. 1, 2023, and the fee remission date of April 1, 2024 is the result of a drafting error in the legislation. The Town of Monument is providing this remission form now to assist businesses subject to the law to remit fees in 2023, rather than waiting until 2024 if it helps with tracking and accounting. That said, by law, no fees are required to be remitted until April 1, 2024. First Quarter (January - March) Due April 20th Second Quarter (April - June) Due July 20th Third Quarter (July - September) Due October 20th Fourth Quarter (October - December) Due January 20th The return is due the next business day if the 20th is on a Saturday, Sunday, or legal holiday. If bag fees due to the Town for a particular quarter do not amount to $20 or more, the business may retain those collected fees until such time as they have accumulated at least $20 total and remit in that quarter. However, businesses are required to submit information quarterly whether revenues exceed $20 or not. Line 1. Enter the total amount of carryout bag fees collected Line 2. The percent of carryout bag fees that is to be submitted to Town of Monument Line 3. Multiply Line 1 and Line 2 to calculate the dollar amount that is to be submitted to Town of Monument. The retailer’s check submitted to the Town of Monument should equal line 3. Town of Monument Carry out Bag Fee Return Business Name Reporting Quarter(s) Mailing Address Due Date 1. Total carry out bag fee revenue collected 2. 60% owed to Town 3. Amount owed to Town Authorized Representive: Name: Title: Phone: Email: Signature: Date 60.00% 0.00