Application For Business Tax License And Report Form - Hamilton County, Tennessee (Expired 2002)

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Hamilton County, Tennessee
Class 5
This application along with proper remittance must be received by
Application for Business Tax License and Report to County Clerk As
this office on or before the dates applicable to the classification in
which the business is classified or within 20 days after
Required by Section 67-4-715 Tennessee Code Annotated
commencement of business, for a new business, or a final return
must be made within 15 days after closing of the business, or
October 1, 2002
September 30, 2003
Period
thru
penalty and interest provided by Section 87-4-720 Tennessee Code
Annotated will apply.
In case of fraudulent return, or where no return has been filed, where willful intent exists to defraud, a specific penalty of the tax shall be assessed.
BUSINESS INFORMATION (Please make sure information is correct.)
0
0
Firm Name
State Sales Tax #
0
Mail Address
Local Address
0
City State Zip
City State Zip
Phone
0
Class
5
Account Number
0
Delinquent if not received by
12/01/03
Type of Business-Primary product, vocation or occupation:
0
TAX RATE
Retail/
Food,Gas,Oil
Other
Food,Gas,Oil
Other
Wholesale
Service
TABLE
n/a
0.001000
n/a
n/a
1.
Total Gross for Tax Period (less sales tax)…………………………………………………………...………………………………………………………..…….
1
$
-
Less Deductions - Part C totals from Schedule A on reverse side………..………………………………………………………...…………………………..
2.
2
$
-
Taxable Gross - Line 1 less Line 2…………………………………………………..………………………………………………………………………………..
3.
3
$
-
4. What dollar amount of Line 3 was:
Retail / Service 4(a)
$
-
Wholesale 4(b)
$
-
5. a. Divide 4(a) by 3:
Ret./Ser. % 5(a)
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b. Divide 4(b) by 3:
Wholesale % 5(b)
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If 5(a) and 5(b) are both percentages greater than 20% complete 6. If either 5(a) or 5(b) is less than 20% SKIP to 7.
6. (a) Multiply 4(a) by your Retail/Service Rate (see Tax Table)
6(a)
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(b) Multiply 4(b) by your Wholesale Rate (see Tax Table)
6(b)
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(c) Add Lines 6(a) and 6(b)……………………………………………………………………………………………
6(c)
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If you completed line 6 above, SKIP to Line 8.
7. If 5(a) is a larger percentage than 5(b) use the Retail/Service rate (see Tax Table). If 5(b) is a larger percentage than 5(a) use the Wholesale rate (see Tax Table.)
Multiply Line 3 by your Retail/Service or Whoesale tax rate as instructed above………………………………
7
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Tax Due. Enter amount from EITHER Line 6(c) OR 7……………………………………………………………
8.
8
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Local Allocation: Multiply Line 8 by .6667……………………………………………………………………….…
9.
9(a)
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State Allocation: 8 less 9(a)………………………………………………………………………………………………………………………………………………
9(b)
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10. Credits A. Minimum Tax
License #
0
10(a)
$
-
B. Personal Property Tax
Bill #
0
Date
1/0/00
Amt.
10(b)
$
-
Total Credits - 10(A) plus 10(B) (Proof of allowable credits must be submitted with return.)…………………………
10(c)
$
-
Subtotal--11(A): 9(A) less 10(C). 11(B): If line 8 is less than $15.01 enter $0; otherwise bring down 9(B).
11.
11(a)
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11(b)
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12. Penalty - 5% for each 30 day period or portion thereof for which tax is delinquent - Not to exceed 25%
A. Local - Apply penalty rate to Line 11(A) - Minimum penalty is $15.00……………………………………………….
12(a)
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B. State - Add 11(A) and 9(B); apply penalty rate; subtract 12(A) If result is less than zero, enter zero………………………………………………………
12(b)
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A. Rate x # of days delinquent x 11(A)………………… 13(a)
13. Interest - Effective daily rate
0.000226
$
-
B. Rate x # of days delinquent x 11(B)……………………………………………………………
13(b)
$
-
A. Local - Add 11(A), 12(A) and 13(A) …………………………………………………………….….
14. Subtotal
14(a)
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B. State - Add 11(B), 12(B) and 13(B) If result is less than zero, enter zero…………….………………………………………………………
14(b)
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15. COMBINE LOCAL and STATE AMOUNTS - Add 14(A) and 14(B) …………………………………………………
15
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16.
Collecting and Recording Fees ($5 per location)……………………………………………………………………………
16
$
5.00
17. Minimum Tax for Period. Tax due regardless of credit entered on 6(C) above ($15 per location).
Yearly Report……………………………………………….………………………….………………
17
$
15.00
18. Penalty - 5% of Line 17 for each 30 day period or portion thereof for which tax is delinquent - Max 25%
MAKE CHECK in
18
$
-
Rate x # of days delinquent x Line 17…………………
19. Interest - Effective daily rate
AMOUNT of LINE 20 TO
0.000226
19
$
-
20. TOTAL Tax - Add Lines 15, 16, 17, 18 and 19…………………………………………………………………………….
W. F. (Bill) Knowles
20
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STOP - Please sign your return before mailing.
I certify that this return, including any accompanying schedule or statements, has been examined by me and is, to the best of my knowledge and belief, a true and complete return, made in good faith,
for the tax period stated pursuant to the provisions of Chapter 4 of Title 67, Tennessee Code Annotated, known as the "Business Tax Act." If prepared by anyone other than the taxpayer, this return
is based upon all information of which I have any knowledge, under the penalties provided by the "Return Preparer Act of 1969." This return is for the tax period:
October 1, 2002
September 30, 2003
to
Signature of Individual, member of firm, or officer or corporation
Date
Signature of preparer, including title if employee of the taxpayer
Date
If person preparing return is not an employee of the taxpayer, state name of Attorney, CPA or PA and signature of employee preparing return.
TAXPAYER MUST FILE EVEN THOUGH NO TAX IS DUE
W.F. (Bill) Knowles
Room 201 Courthouse
Chattanooga, TN 37402
Schedule A
Deductions for Business Tax Purposes (to be used on Line 2 on front side of report)
Deductions must have adequate records of support to qualify.

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