Form Mt - Mercantile Tax - City Of Pittsburgh

SECTION B

ALL TAXPAYERS MUST COMPLETE THIS SECTION

BUSINESS OPERATED AS:

___INDIVIDUAL

___PARTNERSHIP

___ASSOCIATION

___NON-PROFIT CORPORATION

CHECK ONE

___CORPORATION

___S-CORPORATION

___OTHER _______________________________________

___LLC-Limited Liability Company

IF PENNSYLVANIA CORPORATION DATE OF CHARTER:______________

___LLP-Limited Liability Partnership

TAXPAYER IS A :

RESIDENT

___NON-RESIDENT OF PITTSBURGH

____

LIST EACH PLACE OF BUSINESS FOR WHICH THE GROSS VOLUME IS INCLUDED IN THIS RETURN

INCLUDE RIDER, IF ADDITIONAL SPACE IS NEEDED

NAME

ADDRESS

INCORPORATED BUSINESS, LIST NAMES AND ADDRESSES OF OFFICERS

INCLUDE RIDER, IF ADDITIONAL SPACE IS NEEDED

NAME

ADDRESS

SECTION C

REASON FOR EXEMPTIONS & EXCLUSIONS

Must Include Schedules

CITY AMOUNT

SCHOOL AMOUNT

Interstate Transaction (include itemized breakdown)

Manufacturing

Articles of Own Growth

Receipts Subject to Business Privilege Tax

Liquid Fuels Taxes included in Gross Revenues

Pennsylvania Sales Taxes included in Gross Revenues

City of Pittsburgh Amusement Taxes included in Gross Revenues

Receipts not attributable and not allocable to a Pittsburgh place of business

(include breakdown and list addresses)

Other Exemption & Exclusions – Be specific – Include additional sheets if necessary

SECTION D

HOW TO REPORT GROSS REVENUE

If business was operated for the entire previous calendar year, report the total gross revenue of that year on page one.

NEW BUSINESSES:

In the FIRST year of operation, indicate starting date here: __________/__________/__________ and first month’s gross revenue here:

$ ___________________. Multiply the first month’s gross revenue by the number of months, including any fraction thereof; from the starting date to

December 31. The product of this calculation (first month’s revenue multiplied by the number of months and fraction of a month from the starting

date to December 31) is to be reported on page one.

In the SECOND year of operation, calculate tax by multiplying the same first month’s volume of business by twelve (12). Enter the result of this

calculation on page one.

If the business is temporary or seasonal (less than sixty- (60) days’ duration), the actual gross revenue realized during the entire period of operation

is to be reported on page one. Such seasonal and temporary businesses are required to file this return within seven (7) days of the termination of

the business or business activity.

SECTION E

IF THERE WAS A CHANGE FROM LAST YEAR, COMPLETE THIS SECTION

If tax return is not needed next year, enter reason ______________________________________________________________.

Have you discontinued your business or relocated outside the City of Pittsburgh?

If YES, a BUSINESS DISCONTINUATION FORM must be completed and returned for processing.

Form(s) can be downloaded at or call 412-255-2510 to request the form.

Name of New Owner_____________________________________________________________________________________________________

Account Number of New Owner (If known)____________________________________________________________________________________

Address ______________________________________________________________________________________________________________

Unincorporated business, please give residence address of owner(s)__________________________________________________________

Form Mt - Mercantile Tax - City Of Pittsburgh - 2004 Page 2

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