Form E-500 - Sales And Use Tax Return Form
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1
21-11. On Reverse
Tax
Sales and Use Tax Return
.
,
,
12.
Total State and County Tax
North Carolina Department of Revenue
(Add Tax From Lines 4a through 11)
.
,
,
13.
Excess Collections
Period Beginning (MM-DD-YY)
Period Ending (MM-DD-YY)
.
,
,
14.
Total Tax
(Add Lines 12 and 13)
Account ID
.
,
,
15.
Penalty - State and County
.
,
,
Legal Name (First 22 Characters)
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
16.
Interest - State and County
.
,
,
17.
Less Prepayment for This Period
Street Address
.
,
,
18.
Prepayment for Next Period
City
State
Zip Code (5 Digit)
.
,
,
19.
Less any Credit
)
(Attach explanation
.
,
,
$
20.
Total Due
Signature:
Date:
(Add Lines 14-16 & 18, Minus Lines 17 & 19)
I certify that, to the best of my knowledge, this return is accurate and complete.
(
)
Phone:
Title:
MAIL TO: P.O. Box 25000, Raleigh, NC 27640-0700
E-500
10-08
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