Payroll Tax Statement - Long Form - San Francisco Tax Collector - 2006 Page 2

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SCHEDULE C
Payroll Expense
2006
CERTIFICATE
BUSINESS TAX ID
Tax Year
NUMBER
58840
PAYROLL TAX
Column A
Column B
Column C
Locations
No. of taxable SF
Taxable
NAICS Code
Gross Payroll
Exempt Payroll
employees for
(non-SF = 999)
Payroll
2006
DBA Name and Location Address
,
DBA
1
,
,
,
,
.
.
LOC
DBA Name and Location Address
DBA
2
,
,
,
,
,
.
.
LOC
DBA Name and Location Address
DBA
,
3
,
,
,
.
,
.
LOC
DBA Name and Location Address
DBA
,
4
,
,
,
,
.
.
LOC
DBA Name and Location Address
5
DBA
,
,
,
,
,
.
.
LOC
DBA Name and Location Address
6
DBA
,
,
,
,
,
.
.
LOC
DBA Name and Location Address
7
DBA
,
,
,
,
,
.
.
LOC
8
Total
s
SAN FRANCISCO TAX COLLECTOR
PLEASE DO NOT TEAR APART HERE
2006
LONG FORM
BUSINESS TAX SECTION
P.O. BOX 7425
SAN FRANCISCO, CA 94120-7425
PAYROLL TAX STATEMENT
TAXPAYER ASSISTANCE: (415) 554-4400 TTY: (415) 554-4455
PERIOD COVERED: January 1 - December 31, 2006 DELINQUENT IF PAID OR POSTMARKED AFTER FEBRUARY 28, 2007
BUSINESS TAX ID NUMBER
OWNERSHIP NAME
PAYMENT ENCLOSED
NOTE: Payment enclosed must equal the amount due on Line 16 of
(Please write your Business Tax ID or certificate number on your check.)
statement.
Neighborhood Beautification Fund Designation

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