T-1, Virginia Tire Recycle Fee Return

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Form T-1
Virginia Tire Recycling Fee Return
•
Instructions and a worksheet for completing this form can be found on Form T-1A, Worksheet For Computing Virginia
Tire Recycling Fee Return. This and other Virginia tax forms can be obtained from the Department’s website:
virginia.gov.
•
This return must be filed even if no sales were made during the filing period.
•
Make check or money order for the amount on Line 9 payable to Virginia Department of Taxation and mail with return
to:
Virginia Department of Taxation
Virginia Tire Recycling Fee
P.O. Box
26627
Richmond, VA 23261-6627
• Payments returned by the bank will be subject to a returned payment fee in addition to any other penalties that may be
incurred.
• For assistance call (804) 367-8037 or write to:
Virginia Department of Taxation
Office of Customer Services
P.O. Box 1115
Richmond, VA 23218-1115
Line 4. Multiply Line 3 by the rate for the period shown below.
• For filing periods beginning July 1, 2003 through June 30, 2011, the tire recycling fee is $1.00 per tire.
• For the filing periods beginning July 1, 2011 and thereafter, the tire recycling fee will return to $.50 per tire.
Detach at dotted line below. DO NOT SEND ENTIRE PAGE.
T-1
Virginia Tire Recycling Fee Return
(Doc ID 201)
□
Check if Out-of-Business and enter the termination/sold date
For assistance, call (804)367-8037.
Period
Due Date
1
Number of New Tires Sold
2d Total Deductions
000000000000000 2018888 000000
3
Number of New Tires Subject to Fee
(Line 1 less Line 2d)
Account Number
FEIN
4
Recycling Fee
Name
5
Reserved for Future Use
6
Reserved for Future Use
Address
Penalty For Late Filing and Payment
7
City
State
Zip
8
Interest For Late Filing and Payment
I declare that this return (including accompanying schedules and statements) has been examined
by me and to the best of my knowledge and belief is true, correct and complete.
9
Total Amount Due
Signature
Date
Phone Number
6205300 AR W
REV 06/13

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