City Of Salem Tax Return Form
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1CITY OF SALEM
PREPARED FOOD AND BEVERAGE TAX RETURN
Note:
If this is a FINAL RETURN, please notify the City of Salem
Finance Department in writing explaining why this is a final return
Account No. __________
Business Name and Address
Month _____________
1.
Gross Sales of Prepared Food & Beverages _______________
2.
Allowable Deductions
(_______________)
3.
Taxable Sales (Line 1 minus Line 2)
_______________
4.
Tax due (4% of Line 3)
_______________
5.
Seller’s Discount (3% of Line 4 by the 20th) (_______________)
6.
Adjustments from Previous Month
_______________
7.
Net Tax Due
_______________
8.
Penalties (Late Filing)
_______________
9.
Total Due
_______________
th
th
This return is due on or before the 20
of each month to take the discount, and by the 30
to avoid penalties,
following the month in which the tax on prepared food and beverage is made.
Under penalties provided by law, the undersigned certifies that this return is true and accurate to the best of
This/her knowledge and belief and is taken from the books and records of the business for which this return is filed.
Signature __________________________________ Title __________________________________ Date ____________
Please make all checks payable to the City of Salem and remit to City of Salem Treasurer, PO Box 869, Salem VA 24153
CITY OF SALEM
PREPARED FOOD AND BEVERAGE TAX RETURN
Note:
If this is a FINAL RETURN, please notify the City of Salem
Finance Department in writing explaining why this is a final return
Account No. ____________
Business Name and Address
Month __________
1.
Gross Sales of Prepared Food & Beverages _______________
2.
Allowable Deductions
(_______________)
3.
Taxable Sales (Line 1 minus Line 2)
_______________
4.
Tax due (4% of Line 3)
________________
5.
Seller’s Discount (3% of Line 4 by the 20th) (_______________)
6.
Adjustments from Previous Month
_______________
7.
Net Tax Due
_______________
8.
Penalties (Late Filing)
_______________
9.
Total Due
_______________
th
th
This return is due on or before the 20
of each month to take the discount, and by the 30
to avoid penalties,
following the month in which the tax on prepared food and beverage is made.
Under penalties provided by law, the undersigned certifies that this return is true and accurate to the best of
his/her knowledge and belief and is taken from the books and records of the business for which this return is filed.
Signature __________________________________Title __________________________________ Date ____________
Please make all checks payable to the City of Salem and remit to City of Salem Treasurer, PO Box 869, Salem VA 24153
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