Form Wcs-1 - Public Safety Communications Surcharge Return
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1WCS-1
Department of Taxation and Finance
Public Safety Communications Surcharge Return
(4/15)
Tax Law – Article 9, Section 186-f
Mark an X in the appropriate box to indicate the period covered by this return.
Period 116
Period 216
Period 316
Period 416
Mar 1 – May 31, 2015
Jun 1 – Aug 31, 2015
Sep 1 – Nov 30, 2015
Dec 1, 2015 – Feb 29, 2016
Due: Jun 15, 2015
Due: Sep 15, 2015
Due: Dec 15, 2015
Due: Mar 15, 2016
Final return
Taxpayer identification number
Business telephone number
For office use only
Change of
(
)
business
Legal name
information - If
you need to
update your
DBA (doing business as) name
address or phone
information, you
can do so online.
Number and street
See Business
information in the
City, state, ZIP code
instructions.
A. Pay amount shown on line 9. Make payable to: Commissioner of Taxation and Finance
Payment enclosed
(See instructions for details.)
Attach your payment here. Detach all check stubs.
A.
See Form WCS-1-I, Instructions for Form WCS-1, before completing this form.
Enter the appropriate information below for the period covered by this return.
1st month
(multiply number of devices
by 1.20)
1.
1 Total surcharge collected
...........................................
2nd month
2.
(multiply number of devices
by 1.20)
2 Total surcharge collected
...........................................
3rd month
(multiply number of devices
by 1.20)
3.
3 Total surcharge collected
...........................................
(add lines 1, 2, and 3)
4 Total surcharge collected for the period
..........................................................................
4.
(multiply line 4 by 1.166% (.01166); see instructions)
5 Administrative fee
................................................................
5.
(subtract line 5 from line 4)
6 Amount due
..............................................................................................................
6.
(see instructions)
7 Interest calculated on line 4 amount
......................................................................................
7.
(see instructions)
8 Penalty calculated on line 4 amount
......................................................................................
8.
9 Balance due
(add lines 6, 7, and 8 and enter here; enter the payment amount on line A above)
.............................
9.
Mark an X in the box if you are a wireless customer remitting the surcharge directly to the New York State Tax Department .........................
Certification: I certify that the above statements are true, complete, and correct, and that no material information has been omitted. I make
these statements with the knowledge that willfully issuing a false or fraudulent document with the intent to evade tax may constitute a felony
or other crime under New York State Tax Law Article 37, punishable by a substantial fine and a possible jail sentence. I also understand that
the Tax Department is authorized to investigate the validity or the accuracy of any information entered on this document.
Print name
Signature
Title
E-mail address
Date
Telephone number
(
)
Preparer’s signature
Date
Mark an X if
Preparer’s PTIN or SSN
self-employed
Paid
Employer identification number (EIN)
Firm’s name or yours if self-employed
preparer’s
use only
Address
ZIP code
Telephone number
(
)
(see instr.)
Preparer’s e-mail address
Preparer’s NYTPRIN
or
Excl. code
See instructions for where to file.
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