Form Rv-011 - Contractors' Excise Tax Return

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CONTRACTORS’ EXCISE
TAX RETURN
Reporting Period
Return
Return Due
F
CHECK FOR CHANGE OF ADDRESS BELOW
License #
Check if out of business
Last day of business:
EXCISE TAX CALCULATIONS
GROSS
TAXABLE
RATE
TAX DUE
1. Gross Receipts
2. Owner-Furnished Materials
3. Deductions (Subcontractors Receipts, Out-of-state)
4. Special Jurisdiction Receipts (Detail in City Section)
x 2%
5. Net State Excise Taxable (Line 1 plus Line 2, minus Line 3, minus Line 4)
x 4%
6. Net Sales and/or Use Taxable
7. Total State Tax Due (Line 5 plus Line 6)
8. City & Special Jurisdiction Tax Calculation Detail:
9.
City/Special Jurisdiction Name
Code
Taxable
Rate
Tax Due
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22. Total City/Special Jurisdiction Tax (Add Lines 10 through 21)
23. Total Tax Due (Line 7 plus Line 22)
24. Penalty/Interest
25. Adjustment (Previous Credit/Balance Due)
26. Total Due (Line 23 plus Line 24 plus Line 25)
27. Amount Remitted
I declare under the penalties of perjury this return has been examined by me and to the best of my knowledge and belief is a true,
correct and complete return.
Date
Preparer
Date
Licensee
RV-011 12/05

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