Meals Tax
Monthly Report
Report for the month of 20 .
Name:
Trading As:
Contact Person:
Address:
Phone Number:
E-Mail:
Tax on Food and Beverage
1. Gross Receipts from Meals and Beverages $
2. Tax Due (4% of Line 1) $
3. Owner Commission (3% of Line 2) $
4. Penalties (Late Filing 5% of Line 2 $
5. 10% interest after six months $
6. Total Due $
I hereby certify that this report is true and accurate to the best of my knowledge and belief, and herewith transmitted on this date payable to Bath County Treasurer in the amount of $ representing the total amount of Food and Beverage Tax collection by our firm for the month of .
Digital Signature:
Report is due on or before the 20th day of the following calendar month.