Due March 1st
TOWN OF EDINBURG
P.O. BOX 85
EDINBURG, VA 22824
Phone: 540-984-8521
Fax: 540-984-4286
Email: town@shentel.net
Tax Year ___________
Business Name: ______________________________ Owner Name: _________________________
Business Location: _______________________ Business Phone Number: ____________________
Mailing Address: _____________________________________________________________________
Federal Tax ID Number: _____________________ State Tax ID Number: ____________________
For New Business – Date Began: ______________ Owners Home Phone Number: _______________
Type of Business: ___________________________________________________________
Gross Receipts/Purchases Amount: $________________________
Tax or Fee Amount: $________________________
Beer, Wine, and Alcoholic Beverages Fee (if applicable): $________________________
Less Exclusions and Deductions – Specify Nature: $________________________
Penalty and interest for late Filing (10% Penalty): $________________________
Total Tax and Penalties: $________________________
I DECLARE THAT THE STATEMENT AND FIGURES HEREIN GIVEN ARE TRUE COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT THE VIRGINIA DEPARTMENT OF TAXATION MAY BE ASKED TO VERIFY THESE FIGURES.
_____________________________________ ________________________
Signature of Applicant Date
_____________________________________ ________________________
IMPORTANT RETURN WITH CHECK PAYABLE TO: TOWN OF EDINBURG
v Professional Services: $0.15 per $100 of Gross Receipts
v Wholesale: $0.05 per $100 of Gross Receipts
v Carnivals, Circuses, Speedways: $100 per performance
v Fortune Tellers, etc: $1,000.00 per year
v Massage Parlors: $5,000 per year
v Itinerant Merchants or Peddlers: $100.00 per year
v Photographers: $50.00 per year
v Coliseums, Arenas, etc. with a maximum capacity in excess of 10,000 persons: $100.00 per year
v Saving and loan Assoc. and Credit Unions: $50.00 per year
v Direct sellers as defined in code of Virginia – over $4,000 is $0.08 per $100.00 in Retail Sales or $0.05 per $100.00 in Wholesale sales
v Heat, Light, Power and Gas: ½ of 1% of Gross Receipts Derived within Town of Edinburg
v Telephone co.: ½ of 1% of Gross Receipts within Town of Edinburg
v Retailers, Contractors, Constructing for Sale, Repair, Personal and business as follows:
§ Gross Receipts less than $15,000 Flat Fee of $15.00
§ Gross Receipts $15,001 – $50,000: $0.13 per $100 of Gross Receipts
§ Gross Receipts $50,001 - $150,000: $0.11 per $100 of Gross Receipts
§ Gross Receipts $150,000: $0.09 per $100 of Gross Receipts