Form Spt-1 7/05 - Maine Revenue Services - Service Provider Tax

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SPT
Maine Revenue Services
00
Service Provider Tax
*0541000*
Period Begin
Business Code
Period End
Registration No.
Due Date
1. Entity Information
Use this area only to report changes in your business
2. OUT OF BUSINESS?
Check here
, return permit to Bureau and
complete information at right. Date closed:
3. OWNERSHIP CHANGE?
If you have changed ownership, indicate the date
when this occured here
and check the type of change below.
Partner added or dropped
Incorporated
Other (explain on reverse)
Sold to
ADDRESS CHANGE?: If your address above is incorrect, please
4. NAME CHANGE?
Attach explanation to this return.
make the appropriate changes to the preprinted address.
Do Not Use Red Ink!
,
,
.
Gross Services
1.
Services
,
,
.
Exempt Services
2.
,
,
.
Taxable Services
3.
(lines 1-2)
Extended Cable
Private Non-Medical
,
,
,
,
.
.
TV Service
4.
Institution
9.
Community Support
,
,
.
,
,
.
Fabrication Services 5.
Services
10.
Breakdown
Day Habilitation
,
,
,
,
.
.
of Taxable
Video Rentals
6.
Services
11.
Services
Personal Support
,
,
.
,
,
.
Services
Rent-to-Own
7.
12.
Residential Training
,
,
.
,
,
.
Telecom Services
8.
Services
13.
Add lines 4 thru 13.
Total
Total must agree
,
,
.
Services
with Line 3.
14.
Total Tax
,
,
.
Line 14 @ 5%
15.
Credits
,
,
.
Credit Carry Forward From Prior Period
16.
Amount Due
,
,
.
Line 15 less line 16. Use line 18 if the result is a credit amount.
17.
Credit
If line 15 less line 16 is a credit amount, enter the amount to the right. If you wish a refund
,
,
.
Due
rather than a carry forward to the next period, check here
18.
Mail To:
Maine Revenue Service
P.O. Box 1065
Augusta, ME 04332-1065
Print Name
Date
Phone #
Signature/Title
SPT-1 7/05

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