Form Rpd-41210 - Gaming Mfg And Distributor Tax Return Page 2

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RPD-41210
State of New Mexico
Rev. 07/2010
Taxation and Revenue Department
Gaming MFG and Distributor Tax Return
INSTRUCTIONS FOR COMPLETING THIS FORM: Complete all fields on the return.
LINE INSTRUCTIONS: If your Federal Employer ID (FEIN) or Social Security Number (SSN) and CRS ID are not pre-filled,
please enter them for identification purposes. Use the checkboxes to indicate whether the report is an original or amended.
If any information is incorrect on the form, please make changes directly on the form.
1. Gross Receipts:
Enter the manufacturers or distributors gross receipts for the period.
2. Deductions:
Enter the manufacturer deductions on sale, lease or transfer of gaming device
to a licensed distributor.
3. Tax Due:
For Manufacturers, total line 1 minus line 2 multiplied by 10%.
For Distributors, total line 1 multiplied by 10%.
4. Penalty:
2% of Line 3 per month or partial month up to 20% of tax due or $5.00, whichever is greater.
5. Interest:
Line 3 multiplied by the daily interest rate times the number of days the report is late. Interest
rates can change on a quarterly basis. The effective annual and daily interest rates are posted
on the Department's web page at
or can be obtained by contacting the
Department.
6. Total Due:
Enter the total of Lines 3, 4 & 5.
7. Total Paid:
Enter the total amount of remittance included with this return.
Upon completion of the form, sign, date and enter your phone number and E-mail address on return.

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