Form 8ta-Ex - Exclusion Worksheet For Use With The Fairfax County 2006 Bpol
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18TA-EX
EXCLUSION WORKSHEET
FOR USE WITH THE FAIRFAX COUNTY 2006 BPOL
This worksheet should be used to identify all exclusions claimed on the business license applications to include forms: 8TA-FF, 8TA-E1, 8TA-E2, 8TA-
AJ, and 8TA-NE. This worksheet does not replace the business license application(s). It is intended to be used as an attachment to detail certain
adjustments claimed on your business license application(s) that are permitted by statute. If your company is a new business or estimating gross
receipts please estimate as accurately as possible.
Fairfax County
Documentation
Enter amount claimed
Ordinance
Description of Exclusion
To be Provided
for each exclusion
(See Worksheet
Section
Instructions 8TA-EX-IN)
Gross Receipts attributable to taxable business activity
4-7.2-1b (1) B or D
in another jurisdiction or state.
I
Virginia retail sales and use tax or
4-7.2-1b (1) F
Federal and State excise tax on motor vehicle fuel
$
II
__________________
Account Number Assigned by State:
Reseller of hardware or software to Federal or State
4-7.2-1b (1) G
Government entity (
)
III
$
Enter cost of hardware/software
Membership dues collected by nonprofit trade,
4-7.2-1b (1) L
business, professional, service or civic associations
$
IV
501(c)(6) or 501(c)(3)
(Enter Related Income)
4-7.2-1b (1) N or O
V
$
Software developer enter receipts from the lease,
4-7.2-1b (1) Z
license or sale of software product(s) designed,
$
VI
developed or created in Fairfax County
Contractors
(i.e. structural or building, paving, excavating,
4-7.2-24
plumbing, painting, wiring, etc.)
$
VII
Code of Virginia
§58.1-3732.2
Limitation on Gross Receipts; Real Estate Brokers
$
VIII
Code of Virginia
§58.1 – 3732.4
Limitation on Gross Receipts; Staffing Firms
IX
$
Other:(
please specify
code section)
$
X
_______________
Total Exclusion(s) claimed :
$
(
Enter this figure on Line 2/Box 2 on forms 8TA-FF, 8TA-NE, 8TA-AJ, 8TA-E1 or Line 4 on form 8TA-E2)
ATTACH THIS WORKSHEET WITH YOUR SUPPORTING DOCUMENTATION (AS DETAILED IN THE FOLLOWING INSTRUCTIONS)
AND RETURN WITH YOUR COMPLETED BUSINESS LICENSE APPLICATION.
Company Name: ________________________________________
Contact Person (please print): ______________________________
Phone # / Fax #: ________________________________________
Email Address: ___________________________________________
Account Number #: ______________________________________
Ordinance Section: ________________________________________
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Parent category: Financial