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3% MIXED DRINK TAX REPORT This report is due and payable by the 10th day of the month following the month of collection. If the 10th day falls on other than a business day, the report is due the following business day with no penalty. Taxpayers not filing this report on or before the due date shall not be entitled to the operator’s collection fee and any tax due shall bear interest at the rate of one percent per month or portion of month until said tax is paid. I DECLARE UNDER PENALTIES PRESCRIBED THAT THE INFORMATION CONTAINED IN THIS DOCUMENT IS TURE AND CORRECT TO THE BEST OF MY KNOWLEDGE. Name of Business: Signature: Print Name/Title: Report for the month/year of . a. Mixed drink sales: $ b. 3% of Sales $ c. Less 3% of tax as Collection Fee: $ d. Interest rate of 1% of line b if past 10th: $ Net Amount Due: $ To figure out amount due: i.e. Total Sales = a * .03 = b $100 * .03 = $3 b * .03 = c $3 * .03 = $0.09 b * .01 = d $3 * .01 = $0.03 If on time, Amount Due = b – c $3 - $0.09 = $2.91 If late, Amount Due = b + d $3 + $0.03 = $3.03