City of Alexandria, Virginia
DEPARTMENT OF FINANCE
REPORT FOR TAX ON MEALS AND BEVERAGES SOLD
(City of Alexandria Code Section 3-2-241 through 3-2-252)
REPORTING PERIOD:
(Month/Year)
Owner Name___________________________________________ Federal I.D. Number ______________________________
Trade Name ___________________________________________ Business License Number __________________________
Business Location ______________________________________________________________________________________
___________________________________________________________________________________________
1. Meals and Beverage Sales (Excluding Alcoholic Beverages)
$_____________________________
2. Alcoholic Beverage Sales
$_____________________________
3. Taxable Sales (Line 1 plus Line 2)
$_____________________________
4. Tax Due (3% of Line 3)
$___________________________
5. Non-Taxable Sales (T-shirts, Souvenirs, etc.)
$_____________________________
6. Tax Exempt Sales
$_____________________________
7. Total Sales Not Subject to Tax (Line 5 plus Line 6)
$_____________________________
8. Total Gross Sales (Line 3 plus Line 7)
$_____________________________
____________________________________________________________________________________________
Penalty for Late Payment: If the report and payment of the tax are made after the last day of the calendar month following the
month being reported, add penalty and interest as follows:
9. Penalty for Late Payment (10% of amount on Line 4 or $10, whichever is greater)
$_____________________________
10. Interest (Rate of 10% per annum on sum of Lines 4 and 9)
$_____________________________
11. TOTAL TAX, PENALTY AND INTEREST DUE (Sum of lines 4, 9 and 10)
$_____________________________
____________________________________________________________________________________________
I declare that this report has been examined by me and to the best of my knowledge and belief is a true, correct and complete
report.
Preparer’s Name_________________________________________ Signature _____________________________________
Tax payment and reports are due on or before the last day of the calendar month following the month being reported. Please
return this report and payment to the address listed below:
Business Tax Audit Unit
Department of Finance
City of Alexandria - Miscellaneous Tax
Dept. 939
Alexandria, VA 22334-0939
Telephone: (703) 838-3869