Form B-205 - Amusement Gross Receipts Tax Return
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1
2B-205
Amusement Gross Receipts Tax Return
North Carolina Department of Revenue
12-00
BG
Legal Name
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
If this is your first time filing, fill in the
circle that best describes your event:
Monthly
Seasonal
Annual
Trade Name
Fill in circle if receipts are earned
from motion picture shows
Street Address
Return for Month of
Mailing Adress (If Different)
(MM-YYYY)
Account ID
City
State
Zip Code
FEIN or SSN
Contact Person
Phone Number for Contact Person
Part 1.
Computation of Amusement Tax
,
,
,
.
1.
Gross receipts from all amusements except motion picture shows
00
1.
,
,
,
.
2.
Tax on all amusements except motion picture shows
00
Multiply Line 1 by 3%
2.
,
,
,
.
3.
Gross receipts from motion picture shows
00
3.
,
,
,
.
4.
Tax on motion picture shows
00
Multiply Line 3 by 1%
4.
,
,
,
.
5.
Tax Due
00
Line 2 plus Line 4
5.
,
,
,
.
6.
Penalties (10% underpayment)
00
6.
(5% per month, maximum 25% for late filing)
,
,
,
.
7.
Interest
00
7.
,
,
,
.
$
8.
Total Due
00
Add Lines 5, 6, and 7
8.
Signature:
Date:
I certify that, to the best of my knowledge, this return is accurate and complete.
Telephone:
Title:
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 amusement, all
gross receipts for that event are taxable at the 3% rate. Returns are due by the 10th day of each month. A return covers the gross
receipts for the previous month.
MAIL TO: North Carolina Department of Revenue, Post Office Box 25000, Raleigh, North Carolina 27640-0100
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