Fillable Form Bus-V - Rhode Island Business Tax Payment Voucher Form printable pdf download

Form Bus-V - Rhode Island Business Tax Payment Voucher Form

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Complete Form Bus-V - Rhode Island Business Tax Payment Voucher Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

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State of Rhode Island and Providence Plantations

13111599990101

Form BUS-V

Business Tax Payment Voucher Form

Name

Federal employer identification number

Address

For the period ending:

MM/DD/YYYY

Address 2

City, town or post office

State

ZIP code

E-mail address

Part 1: Business Tax Type

Check the box next to the form for which you are making a payment. Check only one box.

Form T-71 - Rhode Island Gross Premium Insurance - Key #13

Form T-71A - Rhode Island Surplus Line Broker Gross Premium - Key #13

Form T-71SP - Rhode Island Self Procurement Insurance Premiums - Key #13

Form T-72 - Rhode Island Public Service Corporation Gross Earnings - Key #22

Form T-74 - Rhode Island Banking Institution Excise - Key #11

Form T-86 - Rhode Island Bank Deposits - Key #10

Mail voucher and payment to:

RI Division of Taxation

One Capitol Hill - Suite 9

Providence, RI 02908-5811

Part 2: Amount due

Amount enclosed.....................................................................................................................

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and

belief, it is true, accurate and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Authorized officer signature

Print name

Date

Telephone number

Paid preparer signature

Print name

Date

Telephone number

Paid preparer address

City, town or post office

State

ZIP Code