Meals Tax Return - Town Of Purcellville
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1TOWN OF PURCELLVILLE
MEALS TAX RETURN
THIS RETURN COVERS THE MONTH OF _____________ , 20 ____
Instructions on reverse
FILE AND PAY BY THE 2OTH OF THE FOLLOWING MONTH.
BUSINESS NAME:
1. Total Gross Sales
2. Total Deductions
BUSINESS ADDRESS:
3. Amount on which tax is calculated
4. Meals Tax (5% of item #3)
5. Less 5% of Tax (#4) Collection Fee
MAILING ADDRESS:
6. Penalty for Late Filing & Payment
7. Interest for Late Filing & Payment
8. Total Tax, Penalty and Interest Due
Signature: __________________________________
Date: ___________
Final Return: ______ Date dissolved: ____________
To the best of my knowledge, I declare that this return is correct and complete.
Return white and canary copies with payment.
TOWN OF PURCELLVILLE
MEALS TAX RETURN
THIS RETURN COVERS THE MONTH OF _____________ , 20 ____
Instructions on reverse
FILE AND PAY BY THE 2OTH OF THE FOLLOWING MONTH.
BUSINESS NAME:
1. Total Gross Sales
2. Total Deductions
BUSINESS ADDRESS:
3. Amount on which tax is calculated
4. Meals Tax (5% of item #3)
5. Less 5% of Tax (#4) Collection Fee
MAILING ADDRESS:
6. Penalty for Late Filing & Payment
7. Interest for Late Filing & Payment
8. Total Tax, Penalty and Interest Due
Signature: __________________________________
Date: ___________
Final Return: ______ Date dissolved: ____________
To the best of my knowledge, I declare that this return is correct and complete.
Return white and canary copies with payment.
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