Clear Form
FORM RV-3
98
STATE OF HAWAII — DEPARTMENT OF TAXATION
THIS SPACE FOR DATE RECEIVED STAMP
(REV. 2010)
RENTAL MOTOR VEHICLE AND TOUR VEHICLE
SURCHARGE TAX ANNUAL
RETURN & RECONCILIATION
FOR CALENDAR YEAR 20
__ __
OR FISCAL YEAR ENDING ___ / ___ / ___
RCF101
MO
DAY
YR
_ _ _ _ _ _ _ _ - _ _
HAWAII TAX I.D. NO. W
LAST 4 DIGITS OF YOUR FEIN OR SSN:
__ __ __ __
NAME:_________________________________________________
COLUMN A
COLUMN B
COLUMN C
Rental Motor Vehicle
TourVehicle SurchargeTax —
TourVehicle SurchargeTax —
Surcharge Tax — Enter the
Enter the Number of Tour
Enter the Number of Tour
Number of Rental Motor Vehicle
Vehicles Carrying 8 - 25
Vehicles Carrying 26 or More
Days
Passengers
Passengers
1 OAHU DISTRICT
1
2 MAUI DISTRICT
2
3 HAWAII DISTRICT
3
4 KAUAI DISTRICT
4
5 TOTALS
(Add lines 1 thru 4 of
5
Columns A, B, and C)
6 RATES
$3
$15
$65
6
7 TAXES
7
(Multiply line 5 by line 6 of
00
00
00
Columns A, B, and C)
8
8
TOTAL TAXES DUE (Add line 7, Columns A through C and enter result here)
9
9
PENALTY assessed during the year
10
10
INTEREST assessed during the year
11
11
TOTAL AMOUNT DUE (Add lines 8, 9, and 10; Enter amount here).
12
12
12
Total taxes paid on monthly, quarterly, or semiannual returns for the period.
13
13
13
Additional assessments paid for the tax year, if included above.
14
14
14
Penalties $ __________ Interest $ __________ paid during the period
15
15
TOTAL PAYMENTS MADE FOR THE TAX YEAR (Add lines 12,13, and 14)
16
16
CREDIT TO BE REFUNDED (Line 15 minus line 11)
17
TOTAL TAXES DUE (Line 11 minus
17
IF YOU DO NOT HAVE ANY ACTIVITY AND THE RESULT IS NO TAX LIABILITY,
ENTER “0.00” ON LINES 8 AND 17. THIS RETURN MUST BE FILED.
line 15)
18a
FOR LATE FILING ONLY
PENALTY
18
18b
INTEREST
19
19
TOTAL AMOUNT DUE AND PAYABLE (Add lines 17 and 18)
Attach your check or money order payable to “HAWAII STATE
PLEASE ENTER THE AMOUNT OF
20
TAX COLLECTOR” in U.S. dollars drawn on any U.S. Bank to
20
YOUR PAYMENT
Form RV-3. Write “RV”, the filing period, and your Hawaii
Tax I.D. No. on your check or money order.
DECLARATION: I declare, under the penalties set forth in section 231-36, HRS, that this is a true and correct return, prepared in accordance with
the provisions of the Rental Motor Vehicle and Tour Vehicle Surcharge Tax Law and the rules issued thereunder.
IN THE CASE OF A CORPORATION OR PARTNERSHIP, THIS RETURN MUST BE SIGNED BY AN OFFICER, PARTNER OR MEMBER, OR DULY AUTHORIZED AGENT.
SIGNATURE
TITLE
DATE
DAYTIME PHONE NUMBER:
(
)
–– MAILING ADDRESS ––
Hawaii Department of Taxation
P. O. Box 2430
Honolulu, HI 96804-2430
98
FORM RV-3