Form B&l: Cst-1 - Coal Severance Tax Report
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B&L: CST-1
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LABAMA
EPARTMENT OF
EVENUE
B
& L
T
D
USINESS
ICENSE
AX
IVISION
Acct. No. _____________________
P.O. Box 327560 • Montgomery, AL 36132-7560 • (334) 353-7827
Control No. ___________________
Online filing available at
Coal Severance Tax Report
PRODUCTION PERIOD
MONTH / YEAR
TITLE 40, CHAPTER 13, ARTICLES I & II
DATE RECEIVED
FEIN: _________________________ SSN: _________________________ Telephone: _____________________________________
Name: ______________________________________________________ Contact Person: _________________________________
Address: ____________________________________________________________________________________________________
City : ________________________________________________________ State: _______________________ ZIP ______________
Check here if new address
Check here if payment made through EFT
Check here if contracting
PERMIT
COUNTY
MUNICIPALITY
TONS
TAX DUE
MINE NAME
NUMBER
CODE
CODE
PRODUCED
@ 20 CENTS PER TON
$
1. Total Tons and Tax Due at 20 Cents Per Ton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
2. State Tax Due at 13.5 Cents Per Ton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
3. Total Tax Due, Municipal, County and State. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
4. Delinquency Penalty (10% of 20 cents tax liability) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
5. Failure to Timely File Penalty (10% of 13.5 cents tax liability or $50.00 whichever is greater) . . . . . . .
$
6. Failure to Timely Pay Penalty (10% of Total tax liability) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
7. Interest Due (Contact the Department of Revenue for rate). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
8. Total Amount Due and Payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AFFIDAVIT
STATE OF ALABAMA, COUNTY of ____________________________________
Before me, the undersigned authority, personally appeared _________________________________________________________
who, being by me first duly sworn, says that he is a duly authorized representative of _______________________________________
_____________________________________________ and that the foregoing statement is true and correct.
Sworn to and subscribed before me this _____________ day of ____________________________ , ___________
Signature _____________________________________________ Notary Public __________________________________________
NOTE: This report must reach the Department of Revenue by the 20th of each month for the previous month.
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