Fillable Contaminaon Tax Return (Minnesota Department of Revenue)

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Contaminaon Tax Return (Minnesota Department of Revenue)

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The Contaminaon Tax Return (Minnesota Department of Revenue) form is 2 pages long and contains:

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County Minnesota Tax ID Number Check here if amended return
Address Contact Person
City State ZIP Code Contact Email Phone Number
For each of the following tax rates, enter the number of Column A Column B
parcels in column A and the tax collected in column B
Number of Parcels Total Tax Collected
(round to nearest dollar)
1 100 percent rate ....................................................... 1
2
25 percent rate
......................................................... 2
3 50 percent rate ......................................................... 3
4
12.5 percent rate
....................................................... 4
Determining the state’s share of the tax collected on lines 3 and 4
5 Total tax collected at 50 percent and 12.5 percent rates
(add line 3, column B, and line 4, column B) ...................................................... 5
6 Counesareallowedtoretain5percentofthetaxcollectedforadministeringthetax .................. 6
7 Total Contaminaon Tax due to the state (mulply line 5 by line 6) .................................. 7
Contaminaon Tax Return
Assessment for Taxes Payable
CN1
(Rev. 06/16)
Reporng Parcels
and Tax
Determining Tax
To pay electronically, go to www.revenue.state.mn.us and log in to e-Services.
To le, email Form CN1 and Schedule A to special.taxes@state.mn.us.
Phone: 651-556-4721
All payments must be paid
electronically (see below)
Print or Type
County Treasurer:UseFormCN1toreportallContaminaonTaxcollectedbythecountyandtodetermineand
pay the state’s share.
ReportparcelspayingtheContaminaonTaxonScheduleA.
Reporngperiod(checkone): First Half Taxes Second Half Taxes
.95
County Treasurer’s Signature Printed Name Date
County Assessor’s Signature Printed Name Date
Sign Here
(year) (year)
MN
County MinnesotaTaxIDNumber Reporngperiod:
First Half Taxes Second Half Taxes
Schedule A CN1 page 2
Report Parcels Paying Contaminaon Tax
Assessment for Taxes Payable Page of
Totals (enter on appropriate
line of Form CN1, column B) .......
Parcel Idencaon Number
(Ex: R32.2232.223) 100% Rate 25% Rate 50% Rate 12.5% Rate
County Assessors and Treasurers:Usethisscheduletoreportparcelspayingthecontaminaontax.Ifnotaxwascollected,enter“none.”Complete
separatesheets,ifneeded.AachallschedulestoFormCN1.
Contaminaon Tax collected at the:
(year) (year)
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Contaminaon Tax Return (Minnesota Department of Revenue)

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Completed 20 November 2020

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