Business Privilege Rental Tax Return Form - 2016

(R)

BUSINESS PRIVILEGE TAX RETURN

2016

(Rental or Lease of Property)

TOWNSHIP OF SPRINGFIELD

DUE 5/31/16

50 POWELL ROAD • SPRINGFIELD, PA 19064

610-544-1300

Name of True Owner(s)______________________________________________________________________________________________

Owner’s Address(es)________________________________________________________________________________________________

________________________________________________________________________ __________ Phone #_________________________

Address of Rental Property/Properties___________________________________________________________________________________

QUESTIONS

1. Is this return based on a full year?

Yes

No

2. If property sold, please give date, name and address of new owner(s)______________________________________________________

PART “A” 2015 TAX REPORT

11. Estimated Gross Receipts on 2015 tax return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ __________________

12. Actual Gross Receipts for 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ __________________

PLEASE ATTACH APPROPRIATE COPY OF FEDERAL TAX FORM SUPPORTING GROSS RECEIPTS FIGURE

13. Business Privilege Tax for 2015-3 mills (.003) x line #2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ __________________

14. CREDITS:

2015 Estimated Tax Payment (Do not include penalty and interest) Same as line #7 on 2015 tax return . . . .($ _________________)

15. Balance Due (or Credit) – line #3 minus line #4 for year ending December 31, 2015 . . . . . . . . . . . . . . . . . . . . $ __________________

PART “B” 2016 TENTATIVE REPORT

16. Total estimated gross receipts. This figure should not be less than line #2.

(If line #2 is not a 12 month figure, estimate a 12 month figure) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ __________________

17. 2016 Estimated Tax – 3 mills (.003) x line #6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ __________________

18. Total Tax Due: (Add line #5 and line #7, if line #5 is a credit, subtract from line #7) . . . . . . . . . . . . . . . . . . . . $ __________________

19. Penalty (10% of line #8 after June 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ __________________

10. Interest (1% per each month late of line #8 starting with June) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ __________________

50.00

11.

LICENSE FEE

- 2016 - Fifty Dollars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ __________________

PART “C” TAX SUMMARY

TOTAL AMOUNT DUE: (line #8 + line #11, plus Penalty and Interest, if applicable) . . . . . . . . . . . . . . . . . . . . . . $ __________________

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

CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF.

___________________________________________________

Signature___________________________________________________

Signature of Person Preparing - If other than Taxpayer

___________________________________________________

Official Title_______________________________ Date_____________

Name and address of Preparer’s Firm

(Owner, Partner, President, etc.)

MAKE CHECK OR MONEY ORDER PAYABLE TO: SPRINGFIELD TOWNSHIP

MAIL TO BUSINESS TAX OFFICE, 50 POWELL ROAD, SPRINGFIELD, PA 19064

(PLEASE DETACH YOUR LICENSE BELOW AT THE PERFORATION)

2016

SPRINGFIELD TOWNSHIP – BUSINESS PRIVILEGE LICENSE (RENTAL)

Account No.

(For the year May 31, 2016 to May 31, 2017)

This license is to be conspicuously displayed upon payment and is valid only for the above named rental property owner(s) and is issued in accordance

with Ordinance No. 1024, enacted January 8, 1980 by the Township of Springfield, Delaware County, PA; under authority granted by the General

Assembly of the Commonwealth of Pennsylvania, approved December 31, 1965, P.L. 1257 as amended.

___________________________________

TOWNSHIP MANAGER