Form B-205 - Amusement Gross Receipts Tax Return
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1
2Amusement Gross Receipts Tax Return
B-205
BG
Web
North Carolina Department of Revenue
6-07
Legal Name
Account ID
Trade Name
FEIN or SSN
Street Address
Return for Month of
Mailing Address (If Different)
(MM-YY)
Fill in circle if receipts are earned from
City
State
Zip Code
motion picture shows.
If this is your first time filing, fill in the
circle that best describes your event:
Contact Person
Phone Number for Contact Person
Monthly
Seasonal
Annual
Part 1.
Computation of Amusement Tax
1.
1.
Gross receipts from all amusements except motion picture shows (From Page 2, Part 2)
2.
Tax on all amusements except motion picture shows
2.
Multiply Line 1 by 3%
3.
Gross receipts from motion picture shows (From Page 2, Part 3)
3.
4.
Tax on motion picture shows
4.
Multiply Line 3 by 1%
5.
Total Due
5.
Add Lines 2 and 4
6.
Penalty (10% for late payment) (5% per month, maximum 25%, for late filing)
6.
Multiply Line 5 by rate above if return with full payment is not timely filed.
7.
Interest (Click
here
for current interest rate.)
7.
Multiply Line 5 by applicable rate if return with full payment is not timely filed.
$
8.
Total Payment Due
8.
Add Lines 5 through 7
Signature:
Title:
Date:
I certify that, to the best of my knowledge, this return is accurate and complete.
This return is used to report the gross receipts earned from any form of entertainment or amusement for which an admission is
charged, including motion picture shows. If the event includes both a motion picture show and another form of entertainment
or amusement, all gross receipts for that event are taxable at the 3% rate. Returns are due by the 10th day after the end of each
month and covers the gross receipts received during the previous month. Mail this form with your check or money order in U.S.
currency from a domestic bank to:
N.C. Department of Revenue, Alcoholic Beverage and Amusement Tax Unit, PO Box 25000, Raleigh, North Carolina 27640-0110
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