Form Mh-1 - Milk Handling Fees

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MH
Maine Revenue Services
Milk Handling Fees
00
*0522000*
Registration No.
Period Begin
Due Date
Period End
06 03 2012
07 25 2012
06 30 2012
1. Entity Information
Use this area only to report changes in your business
2. OUT OF BUSINESS?
Check here
, return permit to Bureau and
complete information at right. Date closed:
3. OWNERSHIP CHANGE?
If you have changed ownership, indicate the date
when this occured here
and check the type of change below.
Partner added or dropped
Incorporated
Other (explain on reverse)
Sold to
ADDRESS CHANGE?: Check here and make the appropriate changes to the
4. NAME CHANGE?
Attach explanation to this return.
preprinted address.
Do Not Use Red Ink!
Gross
,
,
.
Gallons
Gross gallons sold during this fee period
(Report partial gallons as .25, .50 or .75)
1.
Gallons excluded from the handling fee pursuant to Title 36, Chapter 721: (Sales of
Less
individual containers less than 1 quart in volume, containers 20 quarts or larger in volume,
,
,
.
Sales to State or Federal Institutions, and Returns)
2.
Net
,
,
.
Gallons
Line 1 less Line 2.
3.
,
,
.
Total Due
Line 3 times
Fee =
cents per gallon 4.
24.0
0.24
,
,
.
Credits
Credit carry forward from prior period
5.
Amount
,
,
.
Due
Line 4 less Line 5. Use Line 7 if the result is a credit amount.
6.
Credit
If Line 4 less Line 5 is a credit amount, enter the amount to the right. If you
,
,
.
Due
wish a refund rather than a carry forward to the next period, check here
7.
/
Mail To:
Maine Revenue Service
P.O. Box 1065
Augusta, ME 04332-1065
Date
Print Name
Phone #
Signature/Title
MH-1 Revised 02/11
For assistance in completing this form, call (207) 624-9609

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