Form Crl-29 - Real Estate Brokers Affidavit And Schedule In Support Of Gross Receipts Deduction
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2REAL ESTATE BROKERS AFFIDAVIT AND SCHEDULE
IN SUPPORT OF GROSS RECEIPTS DEDUCTION
For the period beginning January 1, 2005, and ending December 31, 2005.
TO BE FILED BY MARCH 1, 2006.
This information may be submitted by diskette, CD or faxed to 703-228-7048, or by e-mail at business@arlingtonva.us.
Business License # ______________________________
Firm’s Name __________________________________
Arlington Place of Business __________________________________________________________________________
SCHEDULE
Firm’s total gross receipts during 2005 ............................................................................................$ ___________________
Independent Contractors’ gross receipts ......................................................................................... $ ___________________
Firm’s adjusted receipts and license basis ...................................................................................... $ ___________________
SALES AGENTS NAME AND ADDRESS
GROSS SHARE $
NAME
STREET ADDRESS
CITY
STATE
ZIP
PHONE:
CELL PHONE:
E-MAIL
NAME
STREET ADDRESS
CITY
STATE
ZIP
PHONE:
CELL PHONE:
E-MAIL
NAME
STREET ADDRESS
CITY
STATE
ZIP
PHONE:
CELL PHONE:
E-MAIL
NAME
STREET ADDRESS
CITY
STATE
ZIP
PHONE:
CELL PHONE:
E-MAIL
NAME
STREET ADDRESS
CITY
STATE
ZIP
PHONE:
CELL PHONE:
E-MAIL
NAME
STREET ADDRESS
CITY
STATE
ZIP
PHONE:
CELL PHONE:
E-MAIL
NAME
STREET ADDRESS
CITY
STATE
ZIP
PHONE:
CELL PHONE:
E-MAIL
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