Meals Tax Form - Town Of Rocky Mount
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2MEALS TAX FORM
Town of Rocky Mount
345 Donald Avenue
Rocky Mount, VA. 24151
Phone: (540) 483-5243
FAX: (540) 483-8830
FOR THE MONTH OF: _______________________
TODAY’S DATE: _________________________
Dealer’s Name: ______________________________________________
State ID#:____________________
Address: ____________________________________________________ Federal ID#: __________________
-----------------------------------------------------------------------------------------------------------------------------------------------------------
ITEM
AMOUNT
1. Gross Sales
2. Personal Use:
price of meals for consumption purchased without payment of meals tax
3. Line #1 + Line #2
4. Amount of exempt sales
5. Line #3 - Line #4 (
)
This is the amount on which the tax must be computed.
6. Meals tax (5
)
% of Item #5
7. 3% Dealers discount – eligible only if paid by due date (
)
Multiply line #6 by discount rate.
8. Line #6 - Line #7
9. Penalty (10% of line 6) for late filing or $10 minimum (
)
See instructions.
10. Interest (10% per annum of line 6 plus line 9) for late filing (
)
See instructions.
11. Total tax, penalty, and interest (Line
)
#8 + Line #9 + Line #10 = total
I declare that this return, including any accompanying schedules and statements, have been examined by me and to the
best of my knowledge and belief is a true and complete return.
__________________________________________________
________________________
Signature
Date
Telephone Number: _________________________________
Prepared by: ______________________________________
MAKE CHECKS PAYABLE TO “TOWN OF ROCKY MOUNT”
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