Form 1280 - Statement Of Payments Made By General Contractors To Subcontractors

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STATE OF DELAWARE

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Department of Finance

STATEMENT OF PAYMENTS

Division of Revenue

MADE BY GENERAL CONTRACTORS

Print Form

820 N. French Street

TO SUBCONTRACTORS

P.O. Box 2340

Wilmington, Delaware 19899-2340

FORM 1280

THIS FORM MUST BE ATTACHED TO CONTRACTOR’S MONTHLY GROSS RECEIPT TAX COUPON

TO SUBSTANTIATE PAYMENTS TO SUBCONTRACTORS

Enter Federal Employee Identification Number

Social Security Number

Name

Address

City

State

Zip

General Contractors Total Monthly Gross Receipts:

Month

Less Payments to Subcontractors:

Name & Address

DE Business License No.

Employer ID No.

Amount of Payment

Business Code

Employer ID No.

DE Business License No.

Business Code

Amount of Payment

Employer ID No.

DE Business License No.

Business Code

Amount of Payment

DE Business License No.

Employer ID No.

Business Code

Amount of Payment

DE Business License No.

Employer ID No.

Amount of Payment

Business Code

(See reverse side for additional space.)

Total Payments to Subcontractors

Total Taxable Gross Receipts for the Month:

* Business Codes 331, 332, 333, 335, 336 or 337. See Reverse side of this form for listing of activities not deductible as amounts paid to subcontractors.

SIGNATURE

TITLE

DATE