Form Cr-L3 - Business License Tax Return - Arlington County - 2003
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1Arlington County
MAIL OR FAX THIS RETURN TO:
2003
BUSINESS LICENSE TAX RETURN
Commissioner of the Revenue
2100 Clarendon Blvd., #200
Mail or fax to (703) 228-7048 by
Expires December 31st.
Arlington, VA 22201-5403
March 3, 2003
Failure to File License Tax Return
FAX: (703) 228-7048 • Info: (703) 228-3060
to Avoid Penalty and Interest
Carries a Criminal Penalty
Email: revenue@co.arlington.va.us
If you have ceased business: Date ceased: _______________________
2002 Gross Receipts: $ _________________________
Name/Address of successor (if any):
!
9.) Businesses Using Installment Payment Check Here
FOR OFFICE USE ONLY
1.) Account Number: ___________________________________________
See Reverse for Eligibility
Date You Began Business in
10.)
2.) Name: ____________________________________________________
Arlington at This Location
/
/
Last
First
MI
!
11.) Check Here if Arlington Business is Residence:
__________________________________________________________
(If Corporation, enter Corporate Name)
12.) Fed. EIN or Soc. Sec. # ___________________________
!
!
!
Mailing Address: ____________________________________________
13.) Individual
Partnership
Corporation
No. / Street
FOR OFFICE USE ONLY
__________________________________________________________
14.) CO # _____________________________________
City
State
Zip
TN #
3.) Arlington Business Address:
15.) Home Address a) Individual, b) Partner or c) Corporation:
No. /Street _________________________________________________
_______________________________________________________
Arlington, VA 222 ________
_______________________________________________________
Telephone (________) ________________________________________
_______________________________________________________
Name and Address of Registered Agent:
4.) Trade Name _____________________________________________
_______________________________________________________
FOR OFFICE USE ONLY
6.) No. of Employees
in Arlington _______
_______________________________________________________
(Annual Average)
5.) Z:
D:
T:
_______________________________________________________
7.) Section 11- __________________ Detail ________________________
Date of Incorporation or
Virginia Qualification: __________ State of Incorporation _______
Business Classification ____________________________________________________________________________________________________
8.) Detailed Description of Business
C
B
A
C
Y
T
A
I
(S
B
F
)
HECK
OX
ND
OMPUTE
OUR
AX
S
NSTRUCTED
EE
ACK OF THIS
ORM
!
16).
Applicant who was in business throughout 2002, enter the gross receipts for 2002 per applicant’s records in Box 20.
!
17).
Applicant beginning business after Jan. 1, 2002, but prior to Jan. 1, 2003, enter gross in 2002 here $ ________________________________
Enter estimated gross in 2003 in Box 20. An adjustment will be made in the succeeding year.
!
18).
Applicant beginning business on or after Jan. 1, 2003, enter estimated gross receipts from beginning of business to Dec. 31,
2003 in Box 20. An adjustment will be made in the succeeding year.
!
19).
License tax not based on gross receipts; enter annual tax in Box 21.
20). GROSS RECEIPTS (to nearest dollar)
,
,
If gross receipts on this license are:
.
,
21.) AMOUNT DUE
* $0-$10,000: AMOUNT DUE is $0; Enter $0 on Line 21
.
,
* $10,001–$50,000: AMOUNT DUE is $30; Enter $30 on Line 21
22.) PENALTY (if late)
.
* $50,001–$100,000: AMOUNT DUE is $50; Enter $50 on Line 21
,
23.) INTEREST (if late)
* Over $100,000: Multiply gross receipts in Box 20 by tax rate.
.
,
Enter AMOUNT DUE on Line 21
24.) TOTAL DUE
FOR OFFICE USE ONLY
DATE:
Print Name/Title
DR
PMD
BY
Signature
/
/ 03
Send this completed form to:
OR * FILE BY FAX *
C
BY
DATE
Commissioner of the Revenue
FAX TO (703) 228-7048
2100 Clarendon Boulevard, #200
P
TAG
ED
BY
Arlington, Virginia 22201-5403
TR
BA
DATE
BY
Send your payment to: Treasurer, Arlington County, P.O. Box 1757, Merrifield, VA
22116-1757 with the payment coupon sent to you by the Treasurer. If you need a
payment coupon, call the Treasurer at (703) 228-3088.
FORM CR-L3 Rev. 1/1/03
Do not mail your payment with this tax return.
Please retain a copy of this return for your records.
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