Form E-234 - Earnings Tax Return
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1
2Form E-234
CALENDAR
CITY OF ST. LOUIS, MO
YEAR
(Rev. 11/00)
EARNINGS TAX RETURN
00
OR TAXABLE YEAR BEGINNING ____________________ AND ENDING__________________
TELEPHONE #:
TYPE OF RETURN:
INDIVIDUAL (E-2)
FEDERAL E.I. or SOCIAL SECURITY #:
PRINCIPAL BUSINESS ACTIVITY:
PARTNERSHIP (LLC) E-3
FEDERAL BUSINESS CODE:
CORPORATION (SUB.S. OR C) E-4
If business is terminated, sold or transferred, indicate: (subject to verification).
Date:
Reason:
To whom sold or transferred:
Address of new owner:
IF ANY EXTENSION OF TIME IS NEEDED
TO FILE FORM E-234, A SEPARATE
REQUEST ON FORM E-8 IS REQUIRED,
(SEE INSTRUCTION SHEET).
VERIFIED BY
AUDITED BY
PLEASE PRINT YOUR NAME AND ADDRESS IN THE SPACE ABOVE
SECTION A - NET PROFIT (Or Loss) (See Instruction Sheet)
1. Gross Receipts or Transactions, less Returns and Allowances
1
$
2. Cost of goods sold (attach schedule)
2
$
3. Gross Profit (Subtract line 2 from line 1)
3
$
4. Other Income (or Loss) (attach schedule)
4
$
5. Total Gross Profit (Add lines 3 and 4)
5
$
6. Business Expenses (Use Section A-1, on back or Separate Schedule)
6
$
7. Net Profit (or Loss) (Subtract line 6 from line 5)
7
$
SECTION B - NET PROFIT BY ALLOCATION (From Section B Worksheet, on back)
8. (a) Allocation percent (line 2)
8a
%
(b) Net Profit by allocation (line 7 Multiplied by line 8a)
b
$
SECTION C - COMPUTATION OF TAX (See Instruction Sheet)
9. Taxable Net Profit (Schedule A, line 7, Schedule B, line 8b or Total of Column 3, Section B-1.)
9
$
10. Earnings Tax Due (1% of line 9) (No Tax Due if less than $1.00)
10
$
11. Payroll Expense Tax Credit (if applicable, Section C-1 on back must be filled in for credit)
11
$
12. Net Earnings Tax Due (line 10 Minus line 11) (No Tax Due if less than $1.00)
12
$
13. Less Amount Paid with Extension Request (if applicable)
13
$
14. Subtotal (line 12 Minus line 13)
14
$
15. Penalty (see instructions)
15
$
16. Interest (see instructions)
16
$
17. Amount Due or Refund (No Refund if under $1.00)
17
$
I declare that this Return has been examined by me and is true, correct and complete to the best of my knowledge and belief.
MAIL TO:
EARNINGS TAX DEPT.
410 CITY HALL
(Date)
(Signature)
(Typed or Printed Name)
(Title)
1200 MARKET ST.
ST. LOUIS, MO 63103-2841
(Signature of preparer other than taxpayer)
(FEIN/SSN of preparer)
(Address, City, State, Zip)
RETURN COMPLETE FORM - DO NOT DETACH - SEE INSTRUCTIONS ON BACK OF COUPON
2000 E-234
.
FEIN #:
14. NET TAX DUE
14.
.
15. PENALTY
15.
NAME:
.
16. INTEREST
16.
.
17. AMOUNT DUE
17.
MAKE CHECKS PAYABLE TO:
RONALD A LEGGETT, COLLECTOR OF REVENUE
TEL.: (314) 622-3291
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