Realty Transfer And Mortgage Tax Return
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1
2TENNESSEE DEPARTMENT OF REVENUE
REALTY TRANSFER AND MORTGAGE TAX RETURN
INTERNET (8-15)
RV-R0002201
Filing Period
Account No.
County Number
PRV
Due Date
County
400
Returns must be postmarked by the
due date to avoid the assessment of
penalty and interest. Returns must
be filed even if no tax was collected.
Name: _________________________________________________
Make your check payable to the Ten-
Address: _______________________________________________
nessee Department of Revenue for
the amount shown on Line 9 and mail
City: __________________________ State: _______ Zip: ________
to:
Tennessee Department of Revenue
Andrew Jackson State Office Bldg.
500 Deaderick Street
Nashville, TN 37242
REMINDERS
IF AN AMENDED
1.
Please read instructions on reverse side before preparing this return.
RETURN
2.
Maintain adequate records to support the return.
CHECK HERE
3.
Sign and date return in the signature box below.
WRITE NUMBERS LIKE THIS
ROUND TO NEAREST DOLLAR
1.
00
Total Realty Transfer Tax collected ......................................................................................................
2.
Total Mortgage Tax collected..................................................................................................................
00
Total collections (Line 1 plus Line 2)....................................................................................................
3.
00
4.
Retained by register ( % of Line 3)....................................................................................................
00
Enter outstanding credit amount from previous Department of Revenue Notice(s)...................
5.
00
6.
TOTAL DUE STATE
(Line 3 less Lines 4 and 5)(See instructions before entering amount due) ...........................................
00
Penalty
7.
(If filed late, compute penalty at 5% of the tax on Line 6 for each 30-day period for which tax is delinquent.
00
Maximum penalty is 25%. Minimum penalty is $15 regardless of amount of tax due, even if there is no tax due.)..........
00
8.
Interest
...............................
(If filed late, interest is computed at
% per annum on the tax (Line 6) from the due date to date paid)
00
9.
TOTAL AMOUNT REMITTED (Total of Lines 6, 7, and 8)...................................................................
00
FOR OFFICE
USE ONLY
I declare this is a true, complete, and accurate return to the best of my nowledge.
SIGN
HERE
County Register
Date
SIGN
HERE
Deputy or Employee
Date
40072000000000000000000000000000000000000000000000000000000000000000
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