Form R-1 - Conveyance Tax Return

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R-1
Conveyance Tax Return
Web
North Carolina Department of Revenue
8-12
DOR Use Only
Return for Month Ended
(MM-DD-YY)
County (USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
Federal Employer ID Number
Mailing Address
NCDOR ID/Account Number
City
State
Zip Code
Name of County Finance Officer
Fill in applicable circles:
Amended Return
Phone Number
Fax Number
Address has changed since prior return
Computation of Conveyance Tax
,
,
.
1.
Gross Amount of Tax Collected on Real Estate Conveyances
1.
00
,
,
.
2.
Monthly County Adjustments (Attach explanation)
2.
00
,
,
.
3.
Net Proceeds of Tax Collected
3.
00
Line 1 minus Line 2
,
,
.
4.
Tax Due Before County Cost Adjustment
4.
00
Multiply Line 3 by 50%
,
,
.
5.
County Cost of Collection and Administration
5.
00
Multiply Line 4 by 2%
,
,
6.
Tax Due
.
6.
00
Line 4 minus Line 5
,
,
7.
Previous Overpayment
.
7.
00
(Attach Letter of Credit Issued by the Department to Claim a Prior Month’s Overpayment)
,
,
.
8.
Total Payment Due
8.
00
Line 6 minus Line 7
Signature of County
Finance Officer:
Date:
I certify that, to the best of my knowledge, this return is accurate and complete.
A county must use this form to remit the State’s net share of the proceeds collected by that county’s register of
deeds. Returns are due by the 15th day following the end of each month.
North Carolina Department of Revenue, PO Box 25000, Raleigh, North Carolina 27640-0110

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