Form Bus 415 - County Business Tax Return - Classification 1c - Fillable

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TENNESSEE DEPARTMENT OF REVENUE
COUNTY BUSINESS TAX RETURN
Filing Period
Account No.
FEIN/SSN/TIN
Business License No.
BUS
415
Due Date
Location Address
Make your check payable to Tennessee
Department of Revenue and mail to:
Tennessee Department of Revenue
Classification
Andrew Jackson State Office Building
1C
500 Deaderick Street
Nashville, Tennessee 37242
Should you need assistance, please contact
the Taxpayer Services Division by calling
_________________________________________________________
Name:
our statewide numbers: 1-800-342-1003
or (615) 253-0600.
_________________________________________________________
Address:
(Address to which returns should be mailed)
}
If this is an AMENDED RETURN,
please check the box at right
________________________________
State:
_____
Zip:
__________
City:
If this is a return for a CLOSED
}
business, please check the
box at right.
Character of Seller (Select one only):
Business tax jurisdiction for which return is being filed:
Wholesaler
Retailer
(Name of county)
Note: A taxpayer located within a city may be required to file two business
tax returns. Please see the instructions for more information.
ROUND TO NEAREST DOLLAR
.00
(1)
1.
Total gross sales (Excluding sales tax)...............................................................................................
.00
2.
Enter deductions from Schedule A, Line 18........................................................................................
(2)
(3)
.00
3.
Taxable gross sales (Subtract Line 2 from Line 1)............................................................................
4.
Business tax (Retailers multiply Line 3 by _________; Wholesalers multiply Line 3 by _________.)
.00
(4)
(If rate is not preprinted, refer to chart on reverse)..............................................................................................
%
.00
5.
Deduct amount of personal property taxes (cannot exceed 50% of Line 4)...............................................................
(5)
% . 00
(6)
6.
Total tax due (Subtract Line 5 from Line 4. Enter result or $22, whichever is greater).........................
%
.00
7.
Enter credit memo balance..........................................................................................................
(7)
%
.00
(8)
8.
Penalty (See instructions)...........................................................................................................................................
%
.00
9.
Interest (
% per annum on taxes unpaid by the due date; see instructions).......................................................
(9)
10.
Total amount due (Add Lines 6, 8, and 9; subtract Line 7)
%
.00
(10)
(Make checks payable to the Tennessee Department of Revenue).............................................................
I declare this is a true, complete, and accurate return to the best of my
FOR OFFICE USE ONLY
knowledge.
SIGN
HERE
President or other Principal Officer, Partner or Proprietor
Date
SIGN
HERE
Tax Return Preparer and Title
Date
INTERNET (07-09)
RV-R0012301

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