Wv Business & Occupation Tax Return-Gross Income-Quarterly Report Form Page 3
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4THE CITY OF MORGANTOWN, WV
BUSINESS & OCCUPATION TAX RETURN (GROSS INCOME)
TIME PERIOD COVERS:
REMIT TAX RETURN AND PAYMENT TO:
ANNUAL
FINANCE DEPARTMENT
389 SPRUCE STREET
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
CREDIT
GROSS TAXABLE INCOME
TAX DUE
A. MANUFACTURED PRODUCTS
$
0.30
$
40.00
B. RETAILERS, RESTAURANTS, ETC.
$
0.50
$
20.00
C. PUBLIC SERVICE OR UTILITY
$
3.00
$
48.00
TOTAL FROM SCHEDULE C ON BACK
MUST COMPLETE SCHEDULE C ON BACK
(INSERT BELOW)
D. CONTRACTING
$
2.00
$
60.00
E. AMUSEMENTS
$
0.50
$
5.00
TOTAL FROM SCHEDULE A ON BACK
MUST COMPLETE SCHEDULE A ON BACK
(INSERT BELOW)
F. RENTS, ROYALTIES, ETC.
$
1.00
$
18.75
G. SERVICE BUSINESS OR CALLING
$
1.00
$
13.75
H. BANKING
$
1.00
$
2.00
( COMPLETE ENCLOSED SCHEDULE B)
I. WHOLESALERS AND JOBBERS
$
0.15
$
2.00
*
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
$
13.75
CARD EXP._______/_______
SECURITY CODE FROM BACK __ __ __
K. QUARRIED OR MINED PRODUCTS
$
0.30
$
2.00
L. OIL, NATURAL GAS
$
0.30
$
15.00
SIGN NAME
PRINT NAME
M. OTHER NATURAL RESOURCES
$
0.30
$
2.00
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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