Form Nyc-Uxs - Return Of Excise Tax By Vendors Of Utility Services
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3NEW YORK CITY DEPARTMENT OF FINANCE
N Y C
RETURN OF EXCISE TAX BY VENDORS
OF UTILITY SERVICES
UXS
F I N A N C E
FOR USE BY PERSONS (OTHER THAN A LIMITED FARE OMNIBUS COMPANY) NOT
NEW
YORK
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SUBJECT TO THE SUPERVISION OF THE DEPARTMENT OF PUBLIC SERVICE WHO
FURNISH OR SELL UTILITY SERVICES OR OPERATE OMNIBUSES
(Pursuant to Title 11, Chapter 11 of the Administrative Code)
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Check type of return ....................
Final return
Date business ended in NYC
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Initial return
Date business began in NYC
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Amended return
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Check type of business entity ......
Corporation
Partnership
Individual
NAME AND ADDRESS Correct any errors in name, address and identification numbers
:
DATE
/
:
EIN
SSN
:
ACCOUNT TYPE
UXS
:
ACCOUNT ID
:
PERIOD BEGINNING
:
PERIOD ENDING
:
DUE DATE
S C H E D U L E A
Computation of Gross Operating Income
(See instructions on reverse side)
Payment Enclosed
A.
Payment
Pay amount shown on line 24 - Make check payable to: NYC Department of Finance
COLUMN A -
1.17%
COLUMN B -
2.35%
TAXABLE AT
TAXABLE AT
R E C E I P T S F R O M S A L E S A N D S E R V I C E S (without any deductions)
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1. Gas
1.
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2. Electricity
2.
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3. Steam
3.
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4. Water
4.
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5. Refrigeration
5.
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6. Telephony and telephone
6.
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7. Telephony and telegraph
7.
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8. Passenger revenue (omnibus operation)
8.
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9. Miscellaneous (attach schedule)
9.
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10. TOTAL GROSS OPERATING INCOME
10.
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11. Tax at 1.17% of column A, line 10
11.
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12. Tax at 2.35% of column B, line 10
12.
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13. Total (column A, line 11 plus column B, line 12)
13.
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14. Add sales and use tax credited or refunded (from Schedule UTX, Schedule B Total) ( attach form)
14.
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15. TOTAL TAX
15.
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16. Sales and use tax credit (from Schedule UTX, Schedule A, line 4)
16.
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17. Credit for rebates and discounts of charges for energy users (attach schedule)
17.
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18. Previous payment
18.
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19. TOTAL PAYMENTS AND CREDITS (add lines 16 through 18)
19.
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20. If line 15 is larger than line 19, enter balance due
20.
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21. If line 15 is smaller than line 19, enter excess to be applied to: (a) General Corporation Tax, or
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21a.
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(b) Unincorporated Business Tax
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21b.
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22. Penalty (see instructions)
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22.
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23. Interest (see instructions)
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23.
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24. TOTAL REMITTANCE DUE (line 20 plus lines 22 and 23) (Enter payment on line A above)
24.
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I hereby certify that this return, including any accompanying schedules or statements has been examined by me, and is, to the b
est of my knowledge and belief, true, correct and complete.
Preparer's Social Security Number
Signature of owner, partner or officer of corporation
Title
Date
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Check if self-
employed 4
Preparer's signature
Date
Firm's Employer Identification Number
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s Firm's name
s Address
s Zip Code
(or yours, if self-employed)
To Avoid Penalties
To avoid the imposition of penalties, this return must be filed with your remittance in full for the
S E E T H E R E V E R S E S I D E F O R M A I L I N G A N D P A Y M E N T I N S T R U C T I O N S
amount of the tax postmarked within 25 days after the month covered by the return.
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