Motion Picture Theatre Admissions Tax Form
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1Name of Business
Address 1
Address 2
MOTION PICTURE THEATRE ADMISSIONS TAX
THIS FORM IS TO BE USED FOR THE REPORTING OF ADMISSIONS TAX ONLY. FOR OTHER SALES AND/OR USE TAX LIABILITY, USE STANDARD REPORTING FORM.
PERIOD COVERED: 01/01
DATE DUE: 20-FEB-01
ACCOUNT NO.: 014493-00
1.
GROSS ADMISSIONS (If consolidated, use Schedule B below)
$
4.
AMOUNT OF CITY ADMISSIONS TAX (2.0% OF LINE
$
3)
2.
DEDUCTIONS
5.
ADD EXCESS TAX
$
A.
SALES TO GOVERNMENTAL, RELIGIOUS, AND
$
6.
TOTAL TAX SUBJECT TO VENDOR’S FEE (LINE 4 +
$
CHARITABLE ORGANIZATIONS
LINE 5)
B.
TAX IN GROSS
$
7.
DEDUCT VENDOR’S FEE (3% OF LINE 6)
$
C.
OTHER:
$
8.
TOTAL TAX DUE (LINE 6 MINUS LINE 7)
$
OTHER:
$
9.
LATE FILING:
$
OTHER:
$
A. PENALTY: _______________(10% OF
$
LINE 6)
TOTAL DEDUCTIONS
$
B. INTEREST: ______________ (1% OF
$
LINE 6)
3.
NET TAXABLE SALES
$
10.
TOTAL DUE AND PAYABLE
$
SCHEDULE B - CONSOLIDATED ACCOUNTS REPORT
ACCOUNT NUMBER
BUSINESS ADDRESS
TOTAL GROSS ADMISSIONS
NET TAXABLE ADMISSIONS
TOTALS:
$
(Total on line 1 above)
$
(Total on line 3 above)
I HEREBY CERTIFY, UNDER PENALTY OF PERJURY, THAT THE STAEMENTS MADE HEREIN
IMPORTANT NOTICE:
ARE TO THE BEST OF MY KNOWLEDGE TRUE AND CORRECT.
SEPARATE CHECKS
PLEASE MAKE OUT
FOR
_________________________________________________________
BY:
YOUR SALES TAX AND YOUR MOTION PICTURE
TAX.
TITLE: _________________________________________________________
TO ENSURE PROPER CREDIT, PLEASE ENCLOSE
COMPANY: _________________________________________________________
THIS FORM ALONG WITH YOUR CHECK IN THE
ENCLOSED ENVELOPE.
DATE: _________________________________________________________
DO NOT REMIT YOUR STANDARD TAX FORM IN THIS
ENVELOPE.
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