Form 9488 25-11 - Monthly Liquor Tax Return City Of Fayette

Monthly Liquor Tax Return

City of Fayette, Alabama

PO Box 830725

Birmingham, AL 35283-0725

Phone: (800)556-7274 Fax: (205) 423-4099

Email:

Website:

For the Month of ________________, 20_____

Telephone #: _______________________________________________

FEIN/SSN: _________________________________

9488 25-11

The tax levied shall be due and payable in monthly installments on or before the 20

day of the month next succeeding

the month in which sales are made.

1 -

Total Gross Receipts from liquor (excluding beer and table wine)

sold during period:

$___________________________________

2 -

Amount of Tax Due & Remitted (at 6% of line #1 above):

$___________________________________

3 –

Penalty and Interest—If not paid on time

a. Penalty --- 15% of the tax due

$___________________________________

b. Interest --- 3% of Line 4

$___________________________________

4–

Total Amount Due

(Line 2 + Lines 3a & 3b, whichever is applicable)

$___________________________________

This return, including any and all accompanying statements has been examined by me and is to the best of my knowledge and belief, a true and complete return, made

in good faith, for the period stated above

Taxpayer’s Signature____________________________________ Date:_____________________FEIN:_____________________

Print Taxpayer’s Name:__________________________________Telephone:___________________________________________

Paid Preparer’s Signature________________________________ Print Paid Preparer’s Name______________________________

FORM DISCLAIMER:

Please note that the administration and rate changes on the RDS Advisory and RDS tax forms are updated once the required information has been received, verified, and validated in compliance

with RDS policy. Any information received before or after the publication of an RDS Advisory or tax form will not be guaranteed to appear on said forms until all such requirements have been met. RDS is not responsible for

incorrect information and/or improper use of the information provided. All updates are completed on a timely basis once the requirements have been met. For the most current RDS administration and/or rate information

provided, please visit our website at .

RETURNED CHECK DISCLAIMER: When you make a payment by check, you authorize us to use information from your check to make a one-time electronic fund transfer from your checking account according to the

terms of your check or to process that transaction as a check. When we use your check to make an electronic fund transfer, funds may be withdrawn from your checking account as soon as the same day we receive your

payment, and you will not receive your check back from your financial institution. If there are insufficient funds in your checking account, you authorize us to charge a Returned Payment Fee in the amount set forth below

and collect that amount through an electronic fund transfer from your checking account, if permitted by applicable law. IF YOUR CHECK OR OTHER PAYMENT IS RETURNED UNPAID by your bank, we may, if permitted

by applicable law, charge a Returned Payment Fee of $ 50 in KY and VA; $40 in DE and MS; $ 35 in MD; $30 in AL, OH, SC, TN, and TX; $25 in AR, IL, MO, NC and WV; $20 in IN; the greater of 5% of the check or

(i) $30 in GA or (ii) $25 in LA; the greater of 5% of the check or (i) $25 if the check is under $50, (ii) $30 if the check is between $50 and $300 or (iii) $40 if the check is over $300 in FL. Effective July 1, 2010, each returned

item received by RDS due to insufficient funds will be electronically represented to the presenters’ bank no more than two times in an effort to obtain payment. RDS is not responsible for any additional bank fees that will

accrue due to the resubmission of the returned item.

City of Fayette Liquor Tax

04/06/2011