Form Sw-1 - Metropolitan Solid Waste Landfill Fee Monthly Report

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SW-1

Metropolitan Solid Waste Landfill Fee Monthly Report

Due on or before the 20th day of the following month

Name

Minnesota Tax ID Number

Address

For the month of:

City

State

ZIP Code

1 Tons of waste received during the month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Tons of exempt waste residue received from energy and resource recovery

and recycling facilities (attach your schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Tons of other exempt material (attach your schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4 Total tons of exempt waste (add lines 2 and 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

5 Tons of waste subject to metropolitan solid waste landfill fee (subtract line 4 from line 1) . . . . . . . . . . . . . 5

6 Multiply line 5 by $6.66. This is the amount due. Make payment to Minnesota Revenue. . . . . . . . . . . . . . 6

I declare that this form is correct and complete to the best of my knowledge and belief.

Authorized signature

Title

Date

Daytime Phone

Mail to: Minnesota Revenue, Special Taxes Division, Mail Station 3331, St. Paul, MN 55146-3331.

Fax: 651-297-1939. Email: environmental.tax@state.mn.us

(Rev. 7/17)