Fillable Commissioner of the Revenue (Montgomery County, Virginia)

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Commissioner of the Revenue (Montgomery County, Virginia)

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U.S.A. forms for Montgomery County, Virginia

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Montgomery County
Commissioner of the Revenue
Helen P. Royal, Master Commissioner of the Revenue
ACCOUNT NUMBER
BUSINESS NAME
LOCATION
MAILING ADDRESS
State
PHONE NUMBER
EMAIL ADDRESS
CONTACT PERSON
1. GROSS FOOD & BEVERAGE RECEIPTS (do not include any tax receipts) $
2.
A. Food & Beverage paid for by Federal State of Local Governments $
B. Food & Beverage exempted under Va. Retail Sales & Use Tax Act $
C. $
D. Total Deductions $
3. ITEM 1 LESS ITEM 2D (Taxable Receipts-Total Deductions) $
4. FOOD & BEVERAGE TAX (4% of item 3) X
5. UNPAID BALANCE FROM PREVIOUS MONTH $
6. TOTAL FOOD & BEVERAGE TAX DUE $
7. 10% PENALTY FOR LATE PAYMENT $
8. 10% INTEREST PER ANNUM $
9. TOTAL FOOD & BEVERAGE TAX, PENALTY & INTEREST DUE (sum of items 6, 7, 8) $
Mail to:
ALLOWABLE DEDUCTIONS:
Taxpayers - Do not write below this line
Post Mark Date:
Walk-in / Drop box Date:
www.MontVa.com • 540-382-5710 • Fax 540-381-6838
FOOD & BEVERAGE TAX DUE FOR THE MONTH OF
P O Box/Street
Town/City
Zip
FOOD & BEVERAGE TAX COMPUTATION
TYPE OF ESTABLISHMENT
0.04
Other (please specify)
Report and payment due on or before the 20th day of the month following the month during which the tax was collected.
Make checks or money orders payable to the Treasurer of Montgomery County.
DATE
SIGNATURE
IF PAID AFTER DUE DATE, A PENALTY OF 10% OF THE TAX AND INTEREST AT THE RATE OF 10% PER ANNUM WILL BE COMPUTED UPON THE TAX PENALTY FROM THE DATE
SUCH WERE DUE AND PAYABLE.
2020
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Commissioner of the Revenue (Montgomery County, Virginia)

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Completed 18 July 2020

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