Form Eff Q Return - Exhibition Facility Fee Return - Business License Quarterly Filing
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1
2NEVADA DEPARTMENT OF TAXATION
EXHIBITION FACILITY FEE RETURN - BUSINESS LICENSE
QUARTERLY FILING
TID NO:
FOR DEPARTMENT USE ONLY
MAIL ORIGINAL TO:
NEVADA DEPARTMENT OF TAXATION
1550 COLLEGE PARKWAY SUITE 115
DATE:____________________
CARSON CITY NEVADA 89706
CHECK AMOUNT:_____________ CHECK NO:_______
POSTMARK:__________________ INITIALS:________
Return for Quarter Ending:
Due on or Before:
IF POSTMARKED AFTER DUE DATE PENALTY
If the name or address shown is incorrect, the ownership or business
WILL APPLY
location has changed, or if you are out of business, notify the
Tax Examiner at 775-684-2130.
A RETURN MUST BE FILED EVEN IF NO TAX LIABILITY EXISTS
Number of events held_________
1.
TOTAL NUMBER OF BUSINESSES (represents the number of
businesses at each event, multiplied by the number of days each event
was held. See Instructions)
2.
FEE DUE
$
(NUMBER OF BUSINESSES X $1.25)
3.
PENALTY
$
(SEE INSTRUCTIONS FOR RATE)
4.
TOTAL AMOUNT DUE AND PAYABLE
$
5.
TOTAL AMOUNT REMITTED WITH RETURN
$
MAKE CHECK PAYABLE TO:
NEVADA DEPARTMENT OF TAXATION
I HEREBY CERTIFY THAT THIS RETURN INCLUDING ANY ACCOMPANYING SCHEDULES AND STATEMENTS HAS BEEN
EXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IS A TRUE, CORRECT AND COMPLETE RETURN.
RETURN MUST BE SIGNED
___________________________________________
______________
__________________________
SIGNATURE OF TAXPAYER OR AUTHORIZED AGENT
DATE
PHONE NUMBER (WITH AREA CODE)
___________________________________________
___________________________________________
TITLE
FEDERAL TAX ID NUMBER (EIN OR SSN)
EXC-EFF-01.02
EFF Q RETURN
REVISED 08-06-10
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