Master Meter - Utility Users Tax (Uut) Return Form - San Jose, Ca

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MASTER METER - UTILITY USERS TAX (UUT) RETURN
MASTER METER - UTILITY USERS TAX (UUT) RETURN
Master Meter User Name:
Master Meter User Name:
Calendar Tax Year (indicate year):
Calendar Tax Year (indicate year):
Master Meter User Address:
Type of Utility:
Gas
Electric
Water
Calculation of Remittance
1. UUT Collected from Tenants
(Jan-Dec of calendar tax year)
$
Line 1
$
Line 2
2. UUT Paid to Service Supplier (Jan-Dec of calendar tax year)
3. Excess Tax Due (line 1 less line 2)
$
Line 3
st
st
4. 10% 1
Penalty, if not postmarked by January 31
$
Line 4
5. Interest - If remitted within 30 days from due date
$
Line 5
(# of days past due x .0004931507 x [sum of line 3 + line 4])
nd
6. 10% 2
Penalty, if remitted more than 30 days after due date
$
Line 6
7. Interest – If remitted more than 30 days after due date
( # of days past 30 that remitted x .0004931507 x [sum of line 3 + line 4 +
$
Line 7
line 6])
0.00
8. Total Tax Due (add lines 3-7)
$
Line 8
I declare under penalty of perjury that, to the best of my knowledge and belief, the statements herein and on
attachments are true, correct, and complete and that this declaration was executed at (City) _______________,
California on (date) ____________________, 20 _______.
Name
Telephone #
Title
Date
Note to Master Meter User: If you submeter gas, electricity and water, please submit a separate tax return
form for each.
200 E. Santa Clara St, 13th Floor, Finance Department, San José, CA 95113 tel (408) 535-7006 fax (408) 292-6488
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