Monthly Remittance Of Tax On Lodging - Virginia Commissioner Of The Revenue printable pdf download

Monthly Remittance Of Tax On Lodging - Virginia Commissioner Of The Revenue

OFFICE OF THE COMMISSIONER OF THE REVENUE

CITY OF FREDERICKSBURG, VIRGINIA

Phone (540) 372-1004

MONTHLY REMITTANCE OF TAX ON

LODGING

CORPORATE NAME

FEIN

TRADE NAME

ADDRESS

CITY, STATE ZIP

1. Gross receipts for the month of __________________ 20____ ...........................$_________________

2. Less allowable deductions (attach list) .................................................................$_________________

3. Balance taxable .....................................................................................................$_________________

4. 6% tax on item 3 ...................................................................................................$_________________

5. LESS 3% sellers discount on item 4 (

) ....$_________________

ONLY WHEN FILED AND PAID ON TIME

6. Balance – total tax less sellers discount ...............................................................$_________________

7. Penalty for late payment – 10% of item 6 or $2.00 (

) ...$_________________

WHICHEVER IS GREATER

8 Total Tax and Penalty ...........................................................................................$_________________

9. 10% per annum interest on tax and penalty ..........................................................$_________________

Total Tax, Penalty and Interest due and paid herewith..............................................$_________________

MAKE CHECK PAYABLE TO CITY TREASURER

DECLARATION OF SELLER:

I hereby swear or affirm that the amounts listed above are true, correct and complete to the best

of my knowledge and belief for the period stated above.

Date ________________________________

Signature _________________________________

Phone No. ___________________________

Title ______________________________________

INSTRUCTIONS: Mail original copy with check payable to City Treasurer on or before the

day of the month following the month being reported, to:

Commissioner of the Revenue, P O Box 644, City Hall, Fredericksburg, VA 22404-0644

For Office Use

Received by:

____________________________________

______________________________

Date Received in Office

Commissioner of the Revenue

Monthly Remittance Of Tax On Lodging - Virginia Commissioner Of The Revenue