Commissioner of the Revenue
Helen P. Royal, Master Commissioner of the Revenue
Name and Address of Company:
Detail of Tax Refused To Be Paid By Consumer and Adjustments:
Make check payable to Montgomery County Treasurer and mail along with this form to Montgomery County
Commissioner of the Revenue 755 Roanoke St Suite 1A Christiansburg, VA 24073.
Utility Taxes are due on or before the last day of the month following the month being reported.
Reporting for the Month of:
MONTHLY REPORT OF COLLECTIONS OF UTILITY TAX
I hereby certify that the foregoing report is true and accurate to the best of my knowledge and belief.
Total Tax Due and Paid Herewith
www.MontVa.com • 540-382-5710 • Fax 540-381-6838
Less Uncollectible Tax Charged Off
Plus Uncollectible Tax Recovered
click to sign
click to edit