City Of University Place Admissions Tax Return Form printable pdf download

City Of University Place Admissions Tax Return Form

CITY OF UNIVERSITY PLACE

ADMISSIONS TAX RETURN

Legal Name: ___________________________________________________________________________

Name of Business (if different): ____________________________________________________________

Month of _________________, 20_____

Due last day of ________________, 20_____

Business Address: _______________________________________________________________________

List Gross Admission Receipts for the Month: $ _____________________________________________

Number of

Admission or

Amount of Tax on Each

Amount of Tax

Admission

Cover Charge

Admission Ticket (5% of A)

(B x C)

Tickets Issued

SUB-TOTAL

PENALTY

INTEREST

TOTAL DUE

Under penalties provided by Law, the undersigned certifies that this return is true and accurate to the best

of his/her knowledge and belief and is taken from the books and records of the business for which the

return is filed.

Signature:

Date:

Typed or Printed Name:

Title:

M:\Tax Revenue\Admissions Tax\Admissions Tax Return.doc

City Of University Place Admissions Tax Return Form