Form Fab-103 - Food And Beverage Tax Or County Supplemental Food And Beverage Tax - Indiana Department Of Revenue Page 2

Download a blank fillable Form Fab-103 - Food And Beverage Tax Or County Supplemental Food And Beverage Tax - Indiana Department Of Revenue in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Fab-103 - Food And Beverage Tax Or County Supplemental Food And Beverage Tax - Indiana Department Of Revenue with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Form FAB−103
Indiana Department of Revenue
2008
Revised 8/08
Food and Beverage Tax or County Supplemental Food and Beverage Tax
This packet contains Food and Beverage Tax or County Supplemental Food and Beverage Tax return(s) and a Change Form to
report address changes. Your Food and Beverage Tax returns are due thirty days after the end of each month. Make sure the
information on this page is correct and complete.
Payments must be made with U.S. funds.
Please do not include check stubs when
mailing your payments.
Report address changes on the Change Form.
For assistance, call (317) 233−4015, or visit:
0800000084633
*990800000084633*
CHUMLEYS BEER HOUSE
Taxpayer ID Number: 0007177020 001 8
834−838 BROADRIPPLE AVE
Filing Status: MONTHLY
INDIANAPOLIS
, IN 46220
Corresp ID: 0800000084633
Account Number: 108032226
When a business location is closed, please complete form BC−100 and attach appropriate documentation. You may request a BC−
100 by calling (317) 233−4015 or visit Do not print changes or corrections on the individual returns. Use the Change
Form to change your location or mailing address changes only.
If the taxpayer identification number listed on your return is not correct, contact Tax Administration at (317) 233−4015 or by
email at:
A return must be filed by the taxpayer even when no tax is due unless the account has been closed. If not, an estimated return will be
filed by the Department based on the best information available (IC 6−8.1−10−3).
Due Date Notice
If the due date printed on your return falls on a weekend or legal holiday, the payment and return are due on the next business day.
The U.S. Postal Service postmark date determines if a return is timely. Please be aware of your local postal service’s hours of mail
pickup. A payment made (postmarked or initiated by electronic funds transfer) after the due date of the return is subject to a penalty
of 10 percent of the amount due or $5, whichever is greater, plus interest.
Taxpayer ID Number
Change Form
0007177020 001 8
Mail to the Indiana Department of Revenue, P.O. Box 6197, Indianapolis, IN 46206−6197
(Please Print Clearly) This will change your Food and Beverage or County Supplemental Food and Beverage Tax Account only.
New Location Address
New Mailing Address
DBA Name
DBA Name
Address
Address
City
City
ZIP Code
ZIP Code
State
State
County
County
Federal ID#
Federal ID#
(
)
(
)
Telephone Number
Telephone Number
F
Signature
Title
Date

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 3