Short Term Rental Tax Return Form
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1CITY OF STAUNTON, VIRGINIA
OFFICE OF
THE COMMISSIONER OF THE REVENUE
116 WEST BEVERLEY STREET P.O. BOX 4
STAUNTON, VA 24402-0004
SHORT TERM RENTAL TAX RETURN
VIRGINIA SALES TAX REGISTRATION NO. :
REPORT MONTH:
TRADE NAME:
__________________________________________________________________________
PHYSICAL ADDRESS OF BUSINESS:
__________________________________________________________________________
MAIL ADDRESS 1:
__________________________________________________________________________
MAIL ADDRESS 2:
__________________________________________________________________________
CITY:
_____________________________________
STATE: _________ ZIP: __________
$
0.00
1. GROSS RECEIPTS FOR ALL RENTALS
(LINE 1)
$
0.00
2. GROSS RECEIPTS FOR SHORT TERM RENTALS (92 days or less)
(LINE 2)
$
0.00
3. COMPUTATION OF TAX –-- 1% of Line 2
(LINE 3)
0.00
4. PENALTY FOR LATE PAYMENT – 10% OF LINE 3 (MINIMUM $10.00)
$
(LINE 4)
0.00
5. INTEREST – 10% PER ANNUM
$
(LINE 5)
0.00
$
6. TOTAL OF TAX PENALTY & INTEREST (Sum of Lines 4 & 5)
(LINE 6)
$
0.00
7. TOTAL TAX DUE (Sum of Line 3 & 6)
(LINE 7)
THE QUARTERLY RETURNS AND PAYMNET OF TAX SHALL BE FILED WITH THE COMMISSIONER OF THE REVENUE ON THE
FOLLOWING BASIS: LINE 4 AND 5 APPLY TO YOUR RETURN IF YOU FAIL TO FILE BY THE FILE DUE DATE.
FILE DUE
MONTHS COVERED
APRIL 20
JANUARY, FEBRUARY, MARCH
JULY 20
APRIL, MAY, JUNE
OCTOBER 20
JULY, AUGUST, SEPTEMBER
JANUARY 20
OCTOBER, NOVEMBER, DECEMBER
BY SIGNING THIS RETURN, I HEREBY DECLARE THAT THIS RETURN HAS BEEN EXAMINED BY ME AND TO THE BEST OF MY
KNOWLEDGE AND BELIEF IS A TRUE, CORRECT AND COMPLETE RETURN.
SIGNATURE:
_____________________________________________________________ DATE:_________________________
MAKE CHECK PAYABLE TO:
CITY TREASURER, STAUNTON, VA
REMIT TO:
MAGGIE RAGON
COMMISSIONER OF THE REVENUE
P.O. BOX 4
STAUNTON, VIRGINIA 24402-0004
Please make a copy for your records and return this copy with payment.
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