Form Rd-107 - Convention & Tourism Tax - Food Establishment - City Of Kansas City - Missouri

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CONVENTION & TOURISM TAX - FOOD ESTABLISHMENT
City of Kansas City, Missouri
Phone
RD-107
Revenue Division
(816) 513-1120
Free E-filing:
(09/09)
Period From:
Period To:
Legal Name:
FEIN Number:
Mailing Address:
Account ID:
DBA Name:
Due Date:
Business Address:
For changes to name, address or FEIN/SSN, please contact us at or (816) 513-1135.
M
M
D
D
Y
Y
/
/
1. Date if closed
2. "X" if amended
DOLLARS
CENTS
3. Food (excluding liquor)
4. Liquor Sales
5. Gross Receipts
6a. Add Any Gross Receipts not included on line 5 +
6b. Decrease/Exemption to line 5 -
7. Taxable Sales
8. Total Tax Due (Rate: 2% of Taxable Sales)
9. 2% Timely (only if paid before due date) -
10. Tax Due
11. Interest (3% per annum until tax is paid in full) +
12. Penalty (5% per month, not to exceed 25%) +
13. Previous Credit -
Make check payable to: CITY TREASURER
14. Amount Due
DO NOT SEND CASH
Mail Return to: P.O. Box 804107
15. Amount Paid
Kansas City MO 64180-4107
Under penalties of perjury, I declare this to be a true, correct, and complete return f or the tax period stated.
Yes
No
I authorize the Comm issioner of Revenue or delegate to discuss m y return and attachments with m y preparer.
Taxpayer Signature
Print Name
Title
Date
Phone
Preparer's Signature (if other than taxpayer)
Print Name
Title
Date
Phone
Draft

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