Alatax Monthly Occupational Tax Return Form

AlaTax Monthly Occupational Tax Return

Remit To:

PO Box 830725

Birmingham, AL 35283-0725

(205) 324-0088

Taxpayer Name & Address

MAKE CHECK PAYABLE TO: Tax Trust Acct.

Enter your check amount here.

$

__________________________________________

For the Month of:

Jan

Feb

March

Apr

May

June

Jul

Aug

Sept

Oct

Nov

Dec

2008

th

NOTE: This return must be postmarked by the 20

of the following month to be considered timely and avoid late penalties.

Telephone #:

__________________________

FEIN or SS#:

__________________________

Contact Name:_______________________

E-Mail Address:_____________________________________

Jurisdiction

Jurisdiction

# of Employees

Fee

Fee Due

Penalty & Int.

Net Fee Due

Code

Rate

66 -66

9756

Beaverton

1%

9024

Guin

1%

9359

Hamilton

1%

9401

Leeds

1%

9677

Mosses

1%

9702

Shorter

1%

9392

Sulligent

1%

7044

Macon County

1%

Total Taxes Due

I declare, under penalties of perjury, that this return (and any accompanying schedules) has been examined by me and to the best of my knowledge is true, correct and complete.

Signed:__________________________________ Date:_____________________ Telephone:__________________________________

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

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

and/or rate information provided, please visit our website at

Updated for Period of December 2007 and following.