Form Cctd-Euct - Electric Utility Consumption Tax Monthly Report - State Corporation Commission
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1
2ROBERT S. TUCKER
P. O. BOX 1197
DIRECTOR
RICHMOND, VIRGINIA 23218
TEL: (804) 371-9480
FAX (804) 371-9797
pstmail@scc.virginia.gov
PUBLIC SERVICE TAXATION DIVISION
Electric Utility Consumption Tax Monthly Report
Pursuant to §§ 58.1-2900 through 58.1-2903
Date
Month of Billing
Company I/d Number
(SCC assigned)
(Service Provider)
(Contact Person)
(Address)
(City, State, Zip Code)
Monthly Billing
*
Number of Kilowatt Hours
Total
*
State
* Special
Subject to Consumption Tax
KWH
Consumption
Regulatory
Billed
Tax
Tax
No. Kilowatt Hours @
0 - 2,500
No. Kilowatt Hours @ 2,501 - 50,000
No. Kilowatt Hours @
50,000 +
Total
**
Less: Unpaid Taxes to Service Provider
(
) (
)
Pursuant to §58.1-2901(A)
Plus: Net Collections of Delinquent Taxes
Excess Local Consumption Tax Collected
Pursuant to § 58.1-2901(F)
Tax Remitted
10% Penalty For Late Payment
Grand Total Remitted
$____________________
Nonmember State Consumption Tax included above
*If the Consumption Tax computed above includes amounts submitted by Municipal Electric Companies, please attach a separate addendum showing each
amount by locality and tiers as provided by the Municipals. (Responsibility of accuracy of information rests with the Municipals.)
**Attach a list of the names and addresses of consumers that refuse to pay the tax. (Pursuant to §58.1-2901(A) )
***Consumption Tax computed above includes kilowatt hours associated with dusk to dawn lighting. Yes______
No______
I,
,
(Name)
(Title)
Make checks payable to the
of the corporation named above, on oath, do say that this return has been
TREASURER OF VIRGINIA
prepared from the original records of the company, that I have read it and
and send with this notice to:
that it is true to the best of my knowledge, information, and belief; and
PUBLIC SERVICE TAXATION DIVISION
hereby acknowledge same, this
day of
, 20
.
STATE CORPORATION COMMISSION
P.O. BOX 1197
Telephone Number:
(
)
RICHMOND, VIRGINIA 23218
THE ABOVE FORM MUST BE RETURNED WITH YOUR REMITTANCE ON OR BEFORE THE LAST DAY OF THE
SUCCEEDING MONTH OF COLLECTION
CCTD-EUCT-01/10
TYLER BUILDING, 1300 EAST MAIN STREET, RICHMOND, VA 23219 TELECOMMUNICATIONS DEVICE FOR THE DEAF TDD/VOICE: (804) 371-9206
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