Wv Business & Occupation Tax Return-Gross Income-Quarterly Report Form
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4THE CITY OF MORGANTOWN, WV
BUSINESS & OCCUPATION TAX RETURN (GROSS INCOME)
REMIT TAX RETURN AND PAYMENT TO:
TIME PERIOD COVERS:
QUARTERLY
FINANCE DEPARTMENT
389 SPRUCE STREET
DUE DATE:
MORGANTOWN, WV 26505
(CHECK ONE)
_____
INDIVIDUAL
_____
PARTNERSHIP
_____
CORPORATION
_____
OTHER
___________
SPECIFY
1. PHONE #____________________________
3. IF BUSINESS SOLD OR DISPOSED OF DURING THIS PERIOD
WHEN___________________________________________
2. WHEN BUSINESS BEGAN ______________
TO WHOM________________________________________
ADDRESS _______________________________________
RATE PER
ITEM
NET PAYABLE
$100
GROSS TAXABLE INCOME
TAX DUE
CREDIT
A. MANUFACTURED PRODUCTS
$
0.30
$
10.00
B. RETAILERS, RESTAURANTS, ETC.
$
0.50
$
5.00
C. PUBLIC SERVICE OR UTILITY
$
3.00
$
12.00
TOTAL FROM SCHEDULE C ON BACK
MUST COMPLETE SCHEDULE C ON BACK
(INSERT BELOW)
D. CONTRACTING
$
2.00
$
15.00
E. AMUSEMENTS
$
0.50
$
1.25
TOTAL FROM SCHEDULE A ON BACK
MUST COMPLETE SCHEDULE A ON BACK
(INSERT BELOW)
F. RENTS, ROYALTIES, ETC.
$
1.00
$
4.69
G. SERVICE BUSINESS OR CALLING
$
1.00
$
3.44
H. BANKING
$
1.00
$
0.50
( COMPLETE ENCLOSED SCHEDULE B)
I. WHOLESALERS AND JOBBERS
$
0.15
$
0.50
*
OTHER. (SEE LIST BELOW)
SPECIFY
TOTAL TAX COMPUTED
$
PENALTY 5%
FOR FIRST 30 DAYS DELINQUENT AND 1% FOR EACH ADDITIONAL 30 DAYS
$
INTEREST
AT THE RATE OF
8%
PER ANNUM FROM DUE DATE OF RETURN
$
PREVIOUS BALANCE OR OVERPAYMENT
$
TOTAL AMOUNT DUE
(MAKE CHECKS PAYABLE TO CITY OF MORGANTOWN)
$
CREDIT CARD PAYMENTS
RATE PER
*OTHER CLASSIFICATIONS
$100
CREDITS
(CIRCLE ONE) MASTER CARD OR VISA
AMOUNT $______________________
ITEMS
CARD #___________________________________
J. HMO
$
0.50
$
3.44
CARD EXP._______/_______
SECURITY CODE FROM BACK __ __ __
K. QUARRIED OR MINED PRODUCTS
$
0.30
$
0.50
L. OIL, NATURAL GAS
$
0.30
$
3.75
SIGN NAME
PRINT NAME
M. OTHER NATURAL RESOURCES
$
0.30
$
0.50
DECLARATION
I DECLARE UNDER THE PENALTIES OF PERJURY, THAT THIS RETURN (INCLUDING ANY ACCOMPANYING SCHEDULES)
HAS BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IS A TRUE, CORRECT, AND COMPLETE RETURN OF THE BUSINESS
TRANSACTED DURING THE PERIOD COVERED BY THIS RETURN.
________________
________________________________
________________________________________
DATE
SIGNATURE OF TAXPAYER
TITLE OF TAXPAYER
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