Form Ex-012s - Local Exposition Tax Return - Wisconsin Department Of Revenue
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LOCAL
Wisconsin Department of Revenue
PO Box 8946
EXPOSITION TAX
Madison WI 53708-8946
Tab to start / continue
RETURN
SS# or FEIN
Enter
For reporting and paying
Wisconsin Center District
15-digit
Local Exposition Taxes in:
Tax
Tax Account Number
Period Begin Date
Period End Date
Due Date
Account
Number
NO
DASHES
To enter dates above, use the following format: MM DD YYYY
Check if this is an AMENDED return
Enter name and address. Hit "Enter" to start
each new line of the name and/or address.
Check if address change
(Note changes on the back of the form)
Check if business discontinued
(Note changes on the back of the form)
For periods beginning on or after
Complete form using BLACK INK
NO COMMAS
07-01-2010 through 12-31-2010.
1 Taxable Receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Basic
Room Tax
2 Basic Room Tax (multiply Line 1 by
) . . . . . . . . . . . . . 2
0.00
.02
For lodging furnished in: City of Milwaukee
Additional
3 Taxable Receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Room Tax
4 Additional Room Tax (multiply Line 3 by
) . . . . . . . . . . 4
0.00
.07
Food and
5 Taxable Receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Beverage
Tax
0.00
6 Food and Beverage Tax (multiply Line 5 by
) . . . . . . . 6
.005
Rental
7 Taxable Receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Car Tax
0.00
8 Rental Car Tax (multiply Line 7 by
) . . . . . . . . . . . . . . 8
.03
0.00
9 TOTAL TAX DUE (add Lines 2, 4, 6 and 8) . . . . . . . . . . . . . . 9
Amount
10 Interest and Penalty
. . . . . . . . . . . . . . . . . . . 10
(see instructions)
Due
11 TOTAL AMOUNT DUE (add Lines 9 and 10) . . . . . . . . . . . . . 11
0.00
This return must be filed by the due date, even if you have no tax to report. Failure to timely file this return will result in a
late filing fee and may result in additional penalties. Please see the instructions for additional information regarding the
computation of penalties.
I hereby certify that the amounts entered on this return are true and correct to the best of my knowledge and belief.
Contact Name (please print)
Signature
Date
Phone
(
)
FOR DEPARTMENT USE ONLY
Mail return and remittance to:
.
Wisconsin Department of Revenue
PO Box 8946
Madison WI 53708-8946
Phone: (608) 266-2776
E-Mail: DORBusinessTax@revenue.wi.gov
Web site:
EX-012S (R. 8-12)
To Page 2
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