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

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SW-1AR
Annual Report
Exemption from Metropolitan Solid Waste Landfill Fee
and Solid Waste Management Tax for Residue
File by January 30 following the year reported .
Name of facility
Minnesota tax ID number
Street
For the calendar year:
City
State
ZIP code
Site:
Pounds/Cu Yd
Pounds/Cu Yd
Pounds/Cu Yd
Pounds/Cu Yd
Pounds/Cu Yd
Pounds/Cu Yd
1 Total solid waste received at the
facility during the year . . . . . . . . . . . . . 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
If the 85 percent reduction is not met, the exemption will be denied and the appropriate fees will be assessed.
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 . 4/12)

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