Form Slt-5 - Sanitary Landfill Tax Return - New Jersey Division Of Taxation
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1
2State of New Jersey
SLT-5
DIVISION OF TAXATION
(R-1)
SANITARY LANDFILL TAX RETURN
THIS RETURN MUST BE FILED BY THE 20TH DAY
OF THE MONTH FOLLOWING THE TAXABLE MONTH
FOR THE TAXABLE MONTH OF ____________________________________
FACILITY NAME ______________________________________________________________________________________________
FED. ID. NO. ______________________________________________ D.E.P. FACILITY NO. ________________________________
FACILITY SITE ADDRESS ______________________________________________________________________________________
CITY ______________________________ COUNTY ____________________ STATE ___________ ZIP CODE _________________
Waste currently accepted for disposal is measured in
Cubic Yards
Tons
Gallons
Other, explain_________________________________________________
- MAILING ADDRESS IF DIFFERENT THAN ABOVE -
NAME _______________________________________________________________________________________________________
ADDRESS ____________________________________________________________________________________________________
CITY ______________________________ COUNTY ____________________ STATE ___________ ZIP CODE _________________
LANDFILL CLOSURE AND CONTINGENCY TAX
(Reportable in Cubic Yards - if you measure in tons, see instructions)
A
B
C
D
SOLIDS
SOLIDS
LIQUIDS
CUBIC YARDS
TONS
GALLONS
TOTAL
TAX COMPUTATION
1. TAX BASE
(See Instructions)
2. TAX RATE
.15
.50
.002
3. TAX AMOUNT
(Multiply Line 1 by Line 2)
$
$
$
4. TOTAL TAX DUE Add Lines 3A and 3C or, if applicable, Lines 3B and 3C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
5.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
PENALTY AND INTEREST DUE (See Instructions)
6.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
TOTAL AMOUNT DUE (Add Lines 4 and 5)
FOR DIVISION USE ONLY
PAY AMOUNT ON LINE 6 IN FULL. WRITE FEDERAL
IDENTIFICATION NUMBER ON CHECK AND MAKE PAYABLE TO:
STATE OF NEW JERSEY - SLT
REVENUE PROCESSING CENTER
PO BOX 263
TRENTON, NJ 08646-0263
Under penalty of perjury, I declare that this is a true, complete and correct return.
__________________________________________________________________________________________________________________________
(Date)
(Signature of duly Authorized Officer of Taxpayer)
(Title)
(Telephone No.)
__________________________________________________________________________________________________________________________
(Date)
(Tax Preparer’s Signature)
(Preparer’s ID No.)
(Telephone No.)
__________________________________________________________________________________________________________________________
(Name of Tax Preparer’s Employer)
(Employer’s ID No.)
READ INSTRUCTIONS BEFORE COMPLETING RETURN
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