Modesto, CA · Stanislaus County
Utility Users Tax Remittance Form
Utility service providers use this form to report and remit utility users tax to the City of Modesto for a tax period.
What this form is
Utility service providers use this form to report and remit utility users tax to the City of Modesto. It provides fields for the provider’s name, service types, company FEIN, ACH remittance, and tax figures, along with a space to describe non-standard adjustments. Prepare a separate form for each tax period; the signer dates and signs a declaration that the statement and any attachments are true and correct under penalty of perjury.
Who needs it
A utility services provider remitting utility users tax to the City of Modesto needs this form, with a separate form for each tax period.
How to submit it
Mail the completed form to the City of Modesto, Attn: Cashiering Dept. - UUT, P.O. Box 642, Modesto, CA 95353, using a separate form for each tax period.
About notarization
This form is signed and dated without a notary; the signer declares under penalty of perjury that the statement and any attachments are true and correct.
How to submit this form
- 1
Download The Form
Download the Utility Users Tax Remittance Form.
- 2
Complete The Form
Enter the utility provider and service information, tax figures, remittance details, and any non-standard adjustments.
- 3
Prepare Attachments
If you include attachments, the signer’s declaration covers them as true and correct.
- 4
Sign And Mail
Date and sign the declaration, then mail the form to the City of Modesto Cashiering Department at the listed address.
Frequently asked questions
- Do I need a notary for the Utility Users Tax Remittance Form?
- No. The form is signed and dated without a notary, but the signer declares under penalty of perjury that the statement and any attachments are true and correct.
- How do I submit the Utility Users Tax Remittance Form?
- Mail it to City of Modesto, Attn: Cashiering Dept. - UUT, P.O. Box 642, Modesto, CA 95353. Use a separate form for each tax period.
- What information does the form request?
- It requests the utility provider’s name, utility service types, company FEIN, ACH remittance information, tax figures, and a description of any non-standard adjustments.
Need something notarized?
This Utility Users Tax Remittance Form doesn’t need a notary — but if you have another Modesto form that does, a commissioned online notary can help.