Form Sw-1qr - Quarterly Report - Exemption From Metropolitan Solid Waste Landfill Fee And Solid Waste Management Tax For Residue

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SW-1QR
Quarterly Report
Exemption from Metropolitan Solid Waste Landfill Fee
and Solid Waste Management Tax for Residue
File by the 30th day of the month following the end of the reporting quarter .
Name of facility
Minnesota tax ID number
Street
For the quarter ending (mm/dd/yyyy):
City
State
ZIP code
Month:
Month:
Month:
Pounds
Cubic Yards
Pounds
Cubic Yards
Pounds
Cubic Yards
1 Total solid waste received
at the facility . . . . . . . . . . . . 1
2 Total residue and
nonprocessible waste
removed from the facility . . . 2
3 Processed waste (subtract
line 2 from line 1) . . . . . . . . . 3
4 Percent of reduction (divide
line 3 by line 1; result must
be 85% or more) . . . . . . . . . 4
Authorized signature
Title
Date
Daytime phone
Mail to: Minnesota Revenue, Special Taxes Division, Mail Station 3331, St . Paul, MN 55146-3331 .
Phone: 651-282-5770 (TTY: Call 711 for Minnesota Relay) . Email: environmental .tax@state .mn .us
(Rev . 8/12)

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