Mercantile Tax Return Form - 2016 printable pdf download

MERCANTILE TAX RETURN

2016

TOWNSHIP OF SPRINGFIELD

DUE 5/31/16

50 Powell Road

Springfield, PA 19064

610-544-1300

Name of Business___________________________________________________________________________________________________

Business Address____________________________________________________________________________________________________

________________________________________________________________________________ Phone #___________________________

Name(s) of True Owners______________________________________________________________________________________________

Owner’s Address(es)_________________________________________________________________________________________________

________________________________________________________________________________ Phone #___________________________

Type of Business____________________________________________________________________________________________________

QUESTIONS

(Answer fully – use extra sheet if necessary)

1. Is this return based on a full year?

Yes

2. Date business started ___________________________________

3. If you terminated your business, give date ______________________________________

4. Do you lease any departments to others?

Yes

If “yes”, submit schedule showing details.

5. Number of employees at this location ___________________________________________

I DECLARE, UNDER PENALTY OF LAW, THAT ALL STATEMENTS MADE HEREIN AND/OR IN SUPPORTING

SCHEDULES ARE TRUE, CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF

Signature

_________________________________________________________________________________________________

Official Title ___________________________________________________________________ Date_________________________

(OWNER, PARTNER, PRESIDENT, ETC.)

________________________________________________________________________________________________

SIGNATURE OF PERSON PREPARING RETURN – IF OTHER THAN TAXPAYER

_________________________________________________________________________________________________________________________________________

NAME AND ADDRESS OF PREPARER’S FIRM

TELEPHONE #

(PLEASE DETACH YOUR LICENSE BELOW AT THE PERFORATION)

SPRINGFIELD TOWNSHIP – MERCANTILE LICENSE

2016

Account No.

(Valid May 31, 2016 to May 31, 2017)

This license is to be conspicuously displayed upon payment and is valid only for the above named business and is issued in accordance with Ordinance

No. 850, adopted November 24, 1970, as amended, by the Township of Springfield, Delaware County, PA.

___________________________________

TOWNSHIP MANAGER

Mercantile Tax Return Form - 2016