Meals Tax Monthly Report Form - Town Of Gordonsville
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1Town of Gordonsville
112 South Main Street,
P.O. Box 276
Gordonsville, VA 22942
Phone: (540) 832-2233
Fax: (540) 832-2449
MEALS TAX MONTHLY REPORT
MONTH OF
, 20
BUSINESS NAME
BUSINESS ADDRESS
1.
Meals Receipts Subject to Tax
$
2.
Five and One Half Percent
TAX
$
(5 1/2%) of # 1
3.
Five Percent (5%) of # 2
DISCOUNT
$
(To be retained by business if
return filed by due date)
4.
TAX DUE (Line 3 from 2)
$
5.
PENALTY ($10 or 10% of tax due per month
$
or fraction thereof that report and/or payment is
delinquent not to exceed 50%, whichever is
greater.
6.
INTEREST (10.0% APR of tax due per month
$
or fraction thereof that report and/or payment
is delinquent)
7.
TOTAL DUE (Add lines 4, 5, and 6)
$
This return must be filed by the 20th day of the month following the month for which the tax is due to
avoid penalty and interest. Make checks payable to Town of Gordonsville. Mailing address is P.O. Box
276, Gordonsville, Virginia 22942. For additional information, assistance, or clarifications, call the Town
Office at 832-2233.
.
I certify that the figures shown on this form are in accordance with the Meals Tax Ordinance
Signature of Authorized Business Official
Date
Name of Authorized Business Official Print Please
*****FOR OFFICE USE ONLY*****
Date Received by Treasurer _______/_________/__________Postmarked _______/_______/______
Remittance Reconciles
yes
no
(If no, return to Business)
Remittance Posted/Filed
yes
no
By
Date
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