Monthly Tax Report For Tax On Meals And Beverages Sold - City Of Alexandria

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MONTHLY TAX REPORT
FOR
TAX ON MEALS AND BEVERAGES SOLD
(City of Alexandria Code Section 3-2-241 through 3-2-252)
Sales During the Month of
Year
Restaurant Name
Restaurant Location
(Street)
(Zip Code)
Business Name if Different from the Restaurant Name
Federal Identification Number
Business License Number
$
1. Meals and Beverage Sales (Excluding Alcoholic Beverages)
$
2. AJcoholic Beverage Sales
$
3. Taxable Sales (Line 1 plus Line 2)
$
4. Tax Due (3% of Line 3)
$
5. Non-Taxable Sales (T-shirts, Souvenirs, etc.)
$
6. Tax Exempt Sales
$
7. Total Sales Not Subject to Tax (Line 5 plus Line 6)
$
8. Total Gross Sales (Line 3 plus Line 7)
Penalty for Late Payment: If the report and payment of the tax are made after the last day of the calendar month following the month
being reported, add penalty and interest as follows:
$
9. Penalty for Late Payment (1 0% of amount on Line 4 or $1 0, whichever is greater)
$
10. Interest (Rate of 1 0% per annum on sum of Lines 4 and 9)
11. TOTAL TAX, PENALTY AND INTEREST DUE (Sum of lines 4, 9 and 1 0)
$
I declare that this report has been examined by me and to the best of my knowledge and belief is a true, correct and
complete report
Date
Signature
Tax payment and reports are due on or before the last day of the calendar month following the month being reported. Please return
white and yellow copies of reports and payments to the address listed below:
Revenue Administration Division - Taxpayer Assistance Branch - Room 1400
P.O. Box 178
Alexandria, VA 22313
Telephone: (703) 838-4570
FORM EFFECTIVE WITH SALES ON OR AFTER SEPTEMBER 1, 1997
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