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Sales Tax Submission
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Sales Tax Submission
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Name of Entity
*
Date
*
Taxable
*
Non-taxable
*
Note: This amount can be zero.
Food Stamp
Tax Collected
Rent
Gas Gallons
Gas Sales
Gas Commission
ATM Commission
Air/Vacuum Commission
Credit Card Fees
Scratch Offs
Lotto Sales
Lotto Commission
Check Cashing
Vendors Cash Paid Out
Expense Cash Paid Out
Other Notes
Please confirm the terms below
*
I verify that the numbers entered above have been verified correctly and I am liable for any audits by the State Department of Revenue.
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