Filing Of Yearly Gross Receipts Tax Form - County Of Spotsylvania
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1FILING OF YEARLY GROSS RECEIPTS TAX
DEBORAH F WILLIAMS
Account # ________
COMMISSIONER OF THE REVENUE
PO BOX 175
File by June 1, 2005
SPOTSYLVANIA, VA 22553
540-582-7050 x 687
_________________________________________________
_________________________________________________
Company Name
Trade Name
_________________________________________________
_________________________________________________
Mailing Address
Physical Address
_________________________________________________
_________________________________________________
City
State
Zip
City
State
Zip
_____________________________________________________________________________
SECTION A – CALCULATING TAXABLE GROSS
1. Total Gross Receipts for the Period ____________, 20 ___
____________, 20 ___
to .
. . . . .
$ _____________________
Beginning
Ending
2. Less Allowable Deductions (Attach List of Items).
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <$ _____________________>
3. Taxable Gross (Subtract Line 2 from Line 1)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ _____________________
SECTION B – CALCULATING TAX
4. One half of 1% (multiply Line 3 by 1%, then multiply by .5).
. . . . . . . . . . . . . . . . . . . . . . . . .
$ ____________________
SECTION C – PENALTY & INTEREST
5. Late Payment Penalty (if late, multiply Line 4 by 10%)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ ____________________
(All payments not postmarked by the due date will receive a late payment penalty.)
6. Total Tax & Late Payment Penalty (add Line 4 and Line 5)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ ____________________
nd
* Interest will begin to accrue on June 2
at the rate of 10 % per year.
SECTION D- TOTAL DUE
$
TOTAL TAX (plus penalty and interest if applicable)
7.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
110-0000-312-04-01
DECLARATION OF SELLER:
I hereby swear or affirm that the amounts listed above are true, correct and complete to the best of my knowledge and belief
for the period stated above.
Date ___________________
Signed by ________________________________________________________
Phone No________________
Title _____________________________________________________________
Make check payable to: Treasurer, Spotsylvania County.
st
Mail to: Deborah F Williams, Commissioner of the Revenue, PO Box 175, Spotsylvania VA 22553 by June 1
of each year.
Please return the original and a copy to the Commissioner’s Office with payment.
FOR OFFICIAL USE ONLY
Date:
____ /____/_____
Late Penalty
Reviewed By: _______________
Payment Enclosed
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