MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
MUNICIPALITY OF ROBERTSDALE, ALABAMA
LODGING TAX
LODGING TAX
LODGING TAX
LODGING TAX
LODGING TAX
LODGING TAX
LODGING TAX
LODGING TAX
LODGING TAX
LODGING TAX
LODGING TAX
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
ACCOUNT NUMBER ________________________
MAIL THIS RETURN WITH REMITTANCE TO:
MAIL THIS RETURN WITH REMITTANCE TO:
MAIL THIS RETURN WITH REMITTANCE TO:
MAIL THIS RETURN WITH REMITTANCE TO:
REPORTING PERIOD ___________________________________
REPORTING PERIOD ___________________________________
REPORTING PERIOD ___________________________________
REPORTING PERIOD ___________________________________
REPORTING PERIOD ___________________________________
REPORTING PERIOD ___________________________________
(This return only for the business shown below).
(This return only for the business shown below).
(This return only for the business shown below).
(This return only for the business shown below).
(This return only for the business shown below).
Total Amount Enclosed
Total Amount Enclosed
$
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
Has a change occurred in Taxpayer Name, Trade Name, Mailing Address, Business Address, or Number of Outlets?
____Yes ____No
____Yes ____No
____Yes ____No
____Yes ____No
____Yes ____No
____Yes ____No
____Yes ____No
____Yes ____No
____Yes ____No
Is this a final return? ____Yes ____No
Is this a final return? ____Yes ____No
Is this a final return? ____Yes ____No
Is this a final return? ____Yes ____No
Is this a final return? ____Yes ____No
Is this a final return? ____Yes ____No
Is this a final return? ____Yes ____No
Is this a final return? ____Yes ____No
Is this a final return? ____Yes ____No
If yes, attach explanation. _________
If yes, attach explanation. _________
If yes, attach explanation. _________
If yes, attach explanation. _________
If yes, attach explanation. _________
If yes, attach explanation. _________
If yes, attach explanation. _________
If yes, attach explanation. _________
If yes, attach explanation. _________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
(A)
(A)
(B)
(B)
(C)
(C)
(D)
(E)
(E)
Type of Tax/Tax Area
Type of Tax/Tax Area
Gross Sales
Gross Sales
Total Deductions
Total Deductions
Net Taxable
Net Taxable
Tax Rate
Gross Tax Due
Gross Tax Due
(Column A - Column B)
(Column A - Column B)
(Column C X Column D)
(Column C X Column D)
Lodging Tax -
Lodging Tax -
4%
City Limits
City Limits
Lodging Tax -
Lodging Tax -
2%
Police Jurisdiction
Police Jurisdiction
(1) TOTAL TAX DUE
(1) TOTAL TAX DUE
(Total of Column E)
(Total of Column E)
(2) PENALTY (Failure to Timely File)
(2) PENALTY (Failure to Timely File)
(2) PENALTY (Failure to Timely File)
This return must be postmarked by the 20th day of the month following the
This return must be postmarked by the 20th day of the month following the
This return must be postmarked by the 20th day of the month following the
This return must be postmarked by the 20th day of the month following the
This return must be postmarked by the 20th day of the month following the
This return must be postmarked by the 20th day of the month following the
The greater of 10% or $50.00
The greater of 10% or $50.00
The greater of 10% or $50.00
reporting period for which you are filing to be considered a timely return.
reporting period for which you are filing to be considered a timely return.
reporting period for which you are filing to be considered a timely return.
reporting period for which you are filing to be considered a timely return.
reporting period for which you are filing to be considered a timely return.
reporting period for which you are filing to be considered a timely return.
PENALTY (Failure to Timely Pay)
PENALTY (Failure to Timely Pay)
PENALTY (Failure to Timely Pay)
10%
(3) INTEREST
(3) INTEREST
By signing this report I am certifying that this report, including any
By signing this report I am certifying that this report, including any
By signing this report I am certifying that this report, including any
By signing this report I am certifying that this report, including any
By signing this report I am certifying that this report, including any
Item 1 X 1%
Item 1 X 1%
accompanying schedules or statements, has been examined by me and is to
accompanying schedules or statements, has been examined by me and is to
accompanying schedules or statements, has been examined by me and is to
accompanying schedules or statements, has been examined by me and is to
accompanying schedules or statements, has been examined by me and is to
accompanying schedules or statements, has been examined by me and is to
(4) DISCOUNT
(4) DISCOUNT
(4) DISCOUNT
(If timely filed and paid)
(If timely filed and paid)
(If timely filed and paid)
the best of my knowledge and belief, a true and complete report for the period
the best of my knowledge and belief, a true and complete report for the period
the best of my knowledge and belief, a true and complete report for the period
the best of my knowledge and belief, a true and complete report for the period
the best of my knowledge and belief, a true and complete report for the period
the best of my knowledge and belief, a true and complete report for the period
5% on $100 or less / 2% on tax over $100
5% on $100 or less / 2% on tax over $100
5% on $100 or less / 2% on tax over $100
stated.
(5) NET TAX DUE
(5) NET TAX DUE
(5) NET TAX DUE
(Timely - Item 1 - Item 4)
(Timely - Item 1 - Item 4)
(Timely - Item 1 - Item 4)
Date: __________
Date: __________
Title: ____________________
Title: ____________________
Title: ____________________
(If delinquent, Items 1 + 2 + 3)
(If delinquent, Items 1 + 2 + 3)
TOTAL AMOUNT DUE & ENCLOSED
TOTAL AMOUNT DUE & ENCLOSED
TOTAL AMOUNT DUE & ENCLOSED
Signature: __________________________________
Signature: __________________________________
Signature: __________________________________
Signature: __________________________________
Signature: __________________________________
Form Date: 04-2009
Form Date: 04-2009