Form Uf-1 - Non-Resident Sports Facility Usage Fee

Form Uf-1 - Non-Resident Sports Facility Usage Fee - 2016

UF-1 2016

NON-RESIDENT SPORTS FACILITY

USAGE FEE

CFD

CITY OF PITTSBURGH

Rev 9/15

Amended Return ( )

Return No Longer Needed ( )

CITY ID

FEDERAL ID

SIGNATURE _____________________________________________

FEE PERIOD

QUARTER

Due on or before

TITLE _____________________ DATE _______________________

PHONE _________________________________________________

E-MAIL ADDRESS ________________________________________

PREPARER’S NAME ______________________________________

PREPARER’S PHONE ______________________________________

I hereby certify, swear and aver that all statements herein are true and correct to the best of my knowledge and

belief, being duly apprised of my duty under the law to submit honest and complete information or be subject to the

penalties provided by law.

Make name/address corrections above

OMISSION OF THE ABOVE APPLICABLE INFORMATION

USE BLACK INK ONLY ON THIS FORM

CONSTITUTES AN INCOMPLETE RETURN

EVENT DATE(S): _______________________

EVENT FACILITY:___________________________

NUMBER OF EMPLOYEES FOR WHOM USAGE FEE IS BEING REMITTED: _____________________

ATTACH THE CONTRACT WITH THE VENUE AND A LIST INCLUDING THE SOCIAL SECURITY

NUMBER, NAME, ADDRESS, PITTSBURGH INCOME AND THE AMOUNT WITHHELD FOR EACH

EMPLOYEE.

COMPENSATION ALLOCABLE TO PITTSBURGH

ADJUSTMENTS – attach explanation

COMPENSATION SUBJECT TO FEE – subtract Line 2 from Line 1

AMOUNT DUE – multiply Line 3 by 3% - (.03)

PENALTY – City penalty 1% per month or fraction thereof

TOTAL DUE – add Lines 4 & 5

TOTAL REMITTANCE WITH THIS RETURN

Make check payable to: TREASURER, CITY OF PITTSBURGH – DO NOT SEND CASH

Mail to: USAGE FEE DUE – 414 GRANT ST RM 206 – PITTSBURGH PA 15219-2476

A $30.00 fee will be assessed for any check returned from the bank for any reason.

For assistance call 412-255-2504.

Form Uf-1 - Non-Resident Sports Facility Usage Fee - 2016