Payroll Tax Statement - Long Form - San Francisco Tax Collector - 2007 Page 2

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SCHEDULE C
Payroll Expense
CERTIFICATE
2007
BUSINESS TAX ID
Tax Year
NUMBER
42357
Column A
Column B
PAYROLL TAX CALCULATIONS
Column C
Locations
No. of taxable SF
Taxable
NAICS Code
Gross Payroll
Exempt Payroll
employees for
(non-SF = 999)
Payroll
2007
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
Totals
SAN FRANCISCO TAX COLLECTOR
2007
PLEASE DO NOT TEAR APART HERE
LONG FORM
BUSINESS TAX SECTION
P.O. BOX 7425
PAYROLL TAX STATEMENT
SAN FRANCISCO, CA 94120-7425
TAXPAYER ASSISTANCE: (415) 554-4400 TTY (HEARING IMPAIRED): (415) 554-4455
PERIOD COVERED: January 1 - December 31, 2007 DELINQUENT IF PAID OR POSTMARKED AFTER FEBRUARY 29, 2008
O WNERSHIP NAME
CERTIFICATE NUMBER
PAYMENT ENCLOSED
NOTE: Payment enclosed must equal the amount due on Line 16 of statement.
(Please write your certificate number on your check.)
Neighborhood Beautification Fund Designation

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