Special Governmental Services Fee Return Form
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1
2NEVADA DEPT OF TAXATION
SPECIAL GOVERNMENTAL SERVICES
FEE RETURN
FOR DEPARTMENT USE ONLY
Mail to:
Received Date:
Nevada Department of Taxation
1550 E. College Parkway #115
Amount:
Check #:
Carson City NV 89706
Due on or before
April 30, 2002
If postmarked after due date
penalty and interest will apply
NOTE: THIS RETURN IS ONLY FOR RENTALS PRIOR TO JANUARY 1, 2002 AND ENDING IN JANUARY 2002.
PLEASE READ INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING RETURN
TOTAL LEASES
$
1.
Enter the total dollar amount of short-term leases upon which 6% fee was assessed (see instructions)
___________
$
2.
MULTIPLY THE TOTAL LEASES (LINE 1) BY 4% (.04)
____________
TOTAL ALLOWABLE REGISTRATION FEES AND TAXES PAID TO DMV
$
3.
DURING PRECEDING CALENDAR YEAR (
See Instructions)
____________
$
4.
SUBTRACT LINE 3 FROM LINE 2 (IF NEGATIVE, ENTER 0)
___________
$
5.
MULTIPLY THE TOTAL LEASES (LINE 1) BY 2% (.02)
___________
$
6.
TOTAL RENTAL FEES DUE (ADD LINES 4 AND 5)
___________
$
7.
PENALTY (10% (.10) OF LINE 6)
___________
$
8.
INTEREST (1.0% (.01) OF LINE 6 FOR EACH MONTH OR FRACTION OF A MONTH LATE)
___________
$
9.
TOTAL AMOUNT DUE AND PAYABLE
___________
$
10.
TOTAL AMOUNT REMITTED WITH RETURN
___________
I hereby certify that this return including any accompanying schedules and statements has been examined by me and
to the best of my knowledge and belief is a true, correct and complete return.
Signature
Name Of Preparer
Title
Fed Id Or Soc Sec #
Phone Number
Date
STL-02a
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