Annual Reconciliation Of 2010 Liquor Tax - City Of Philadelphia

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City Account Number
CITY OF PHILADELPHIA
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ANNUAL RECONCILIATION OF
2010 LIQUOR TAX
DUE DATE: FEBRUARY 28, 2011
Federal Identification Number
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Name and Address
Social Security Number
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If your business terminated, changed address, or changed entity type, use the Change Form.
Failure to file this return by the due date could result in the imposition of fines and legal costs.
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1. TOTAL GROSS RECEIPTS - All Sales Receipts (1/1/2010 - 12/31/2010)...........1.
2. Total Exclusions (Sales Receipts not subject to Liquor Sales Tax)
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a) Food.............................................................................................2a.
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b) Other.............................................................................................2b.
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c) Total Exclusions (Line 2a plus Line 2b)........................................2c.
If you claim exclusions on Line 2c, you must have an entry on Line 2a and/or Line 2b.
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3. Taxable Liquor Sales Receipts (Line 1 minus Line 2c).........................................3.
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4. TOTAL TAX DUE (Line 3 times 10%)..................................................................4.
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5. Tax previously paid for 2010.................................................................................5.
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6. ADDITIONAL TAX DUE If Line 4 is greater than Line 5, enter here...................6.
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7. TAX OVERPAID If Line 5 is greater than Line 4, enter here...............................7.
Under penalties of perjury, as set forth in 18 PA C.S. §§ 4902-4903 as amended, I, a person required under § 19-1507 of the
Philadelphia Code to collect, truthfully account for and pay over any tax due under this return, swear that I have reviewed this return
and accompanying statements and schedules, and to the best of my knowledge and belief, they are true and complete.
Taxpayer Signature________________________________________ Date_______________________Phone #_________________________
Preparer Signature_________________________________________ Date_______________________Phone #_________________________
MAIL TO: PHILADELPHIA REVENUE DEPARTMENT
P.O. BOX 1670
PHILADELPHIA, PA 19105-1670
QUESTIONS: 215-686-6600 E-MAIL: revenue@phila.gov
2010 Liquor Tax Internet 9-22-2010 Final

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