Election To Pay Use Tax On Lease/rental Charges Form - 2006

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NEVADA DEPARTMENT OF TAXATION
1550 COLLEGE PARKWAY #115
CARSON CITY, NEVADA 89706
775-684-2000
ELECTION TO PAY USE TAX ON LEASE/RENTAL CHARGES
Nevada Permit No.
Date
Name of Business
Street Address
City, State
This form is to be used by all businesses that lease or rent out any items of tangible personal property in Nevada and elect to
pay use tax on the lease/rental charges instead of the acquisition cost. The taxpayer/business may make a blanket election on all
items of tangible personal property leased or rented out by this taxpayer/ business.
Please mark the appropriate box:
( ) The above business elects to remit use tax on lease/rental charges on all items of tangible personal property leased or
rented out beginning _____________, 200_.
( ) The above business elects to remit use tax on the lease/rental charges on the item(s) listed below. Describe the type of
item, serial number, vehicle identification number, or other type of description that will identify the particular item. If there are
more items of tangible personal property than those listed below, please attach a detailed listing to this form.
MUST BE WITNESSED BY A NOTARY PUBLIC OR AN AUTHORIZED EMPLOYEE OF THE DEPT TAXATION
_____________________________________________
__________________
(Taxpayer Authorized Signature)
(Date)
_____________________________________________
__________________
(Nevada Dept of Taxation Authorized Signature)
(Date)
*********************************
State of
County of
On
,
(Month)
(Day)
(Year)
(Name)
personally appeared before me and in my presence signed this document.
(Notary Public)
(Date Commission Expires)
(SEAL)
In the event the taxpayer/business does not make a blanket election, the lessor is required to complete the form within 10 days
of the acquisition of the respective item of tangible personal property and date the form accordingly.
This form is to be maintained with the business records and made available to the Department of Taxation for examination.
The election to pay use tax on lease agreements is only applicable to lease agreements that constitute a true lease. See NAC
372.070
APP-02.08
Revised 10/04/06

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