Utility Tax Form California

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UTILITY TAX
CITY OF NORWALK, CALIFORNIA
Period Covered
Date Due
th
(30
Day of the Proceeding Month)
Company Name and Address:
Make Remittance Payable to:
City of Norwalk
Attn: Finance Department
12700 Norwalk Blvd.
Norwalk, CA 90650
1. Total Revenues
2. Adjustments
3. Net Taxable Revenues
4. City Tax Rate
5.5%
5. Total Tax Due
I declare that all information provided herein is true, complete and accurate to the best of
my knowledge.
__________________________________
Date: ________________________
Signature

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