Form Lm1 9001 - License/excise Tax Return - 2012
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1DELAWARE DIVISION OF REVENUE
LEM54
LICENSE/EXCISE TAX RETURN - FORM LM1 9001
0054-01
ACCOUNT NUMBER
TAX PERIOD ENDING
DUE ON OR BE FORE
BUSINESS CODE GROUP DESCRIPTION
707 PBL UT CTV/SAT
0-000000000-000
01-31-12
02-21-12
Reset
00540106000000000000001311202211200000000007070000000
Print Form
BUSINESS NAME AND ADDRESS
TAXABLE BASIS
0
_________________ X .02125 = $________________
GROSS RECEIPTS
$
.00
0
AMOUNT DUE
Mail This Form With Remittance Payable To:
AUTHORIZED SIGNATURE
I declare under penalties of perjury, that this is
DATE
TELEPHONE NUMBER
Delaware Division of Revenue
a true, correct and complete return.
P.O. Box 2340, Wilmington, DE 19899-2340
For questions, call (302) 577-8780
If desired, provide an e-mail address where we may contact you regarding this return.
E-MAIL ADDRESS
CUT ALONG THIS LINE AND SEND THE ABOVE PORTION WITH ANY PAYMENT DUE
LICENSE/EXCISE TAX RETURN - MONTHLY
Complete the return above, sign, date and file by the due date. You may file all monthly or quarterly returns at the end of the year if no tax is
due on any of the returns.
To Update Your Contact/Business Information on File with Revenue:
Remit a License Request for Change form
To Change Tax Information You’ve Already Reported:
Remit an Amended return
SPECIFIC LINE INSTRUCTIONS
PLEASE NOTE: THE DIVISION OF REVENUE REQUIRES ROUNDING OF ALL AMOUNTS ON ALL GROSS RECEIPTS RETURNS.
Line 1. - Enter on the first line of your return the amount of gross receipts received from Cable Television.
Line 2. - Multiply Line 1 by .02125 and enter the result in the space provided and in the AMOUNT DUE box.
Line 3. - Sign and date the return and provide your telephone number. Cut along the line provided and mail the form with remittance
due to the address on the return.
For additional information, please contact Thomas Eoppolo at (302) 577-8261 or e-mail thomas.eoppolo@state.de.us.
If you have not already renewed this year’s business license, do it now to avoid a $200 penalty.
Go to
to renew your business license online!
SAMPLE COMPLETED RETURN
TAXABLE BASIS
55,695
1,184.00
_____________X .02125 = $_____________
GROSS RECEIPTS
1,184
$
.00
AMOUNT DUE
Monthly Gross Receipts Tax Returns are due on or before the 20th day of the month following the end of the tax period.
MONTH END
DUE DATE
MONTH END
DUE DATE
MONTH END
DUE DATE
MONTH END
DUE DATE
01/31/2012
02/21/2012
04/30/2012
05/21/2012
07/31/2012
08/20/2012
10/31/2012
11/20/2012
02/28/2012
03/20/2012
05/31/2012
06/20/2012
08/31/2012
09/20/2012
11/30/2012
12/20/2012
03/31/2012
04/20/2012
06/30/2012
07/20/2012
09/30/2012
10/22/2012
12/31/2012
01/22/2013
For questions or to speak with a customer service representative, please call Revenue’s Gross Receipts Department at (302) 577-8780.
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