New Business License Form

Short Term Rental Tax Quarterly Report (1% Rental Tax)

CITY OF DANVILLE OFFICE OF COMMISSIONER OF THE REVENUE
APPLICANT
MAILING ADDRESS
LOCAL BUSINESS ADDRESS
TRADE NAME
LOCAL BUSINESS PHONE
CONTACT PERSON
CONTACT TITLE
CONTACT PHONE
CONTACT EMAIL
Note: No rental tax shall be collected or payable on rentals to Commonwealth of Virginia, to any political subdivision of the Commonwealth, to the United States, for rentals on durable medical equipment as defined in 58.1-608 (22), and all rentals exempt from the Virginia Sales and Use Tax pursuant to chapter 6-58.1. All exemptions shall be proved by filing of the appropriate documentation and subject to verification by Commissioner at any time.
YEAR
REPORTING QUARTER ENDING (CHECK ONE)

MARCH 31JUNE 30SEPTEMBER 30DECEMBER 31

ENTER AMOUNTS FOR THE CALENDAR YEAR SHOWN ABOVE

	AMOUNT
1. TOTAL GROSS RECEIPTS FROM RENTALS OF 92 CONSECUTIVE DAYS OR LESS:
2. TOTAL GROSS RECEIPTS FROM ALL RENTALS:
3. TOTAL EXEMPT RENTALS:
4. TOTAL GROSS TAXABLE RENTALS:
5. TOTAL TAX DUE (1% X LINE 4):
6. LATE PENALTY (10% OF THE TAX PAST DUE OR $10.00, WHICHEVER IS GREATER):
7. INTEREST ON LATE PAYMENTS OF ANY TAXES DUE (10% PER YEAR):
8. TOTAL TAX DUE (ADD LINES 5, 6, AND 7):

I (We), the undersigned, hereby certify under penalty of perjury that the information provided herein and above is true and correct to the best of my (our) knowledge and belief.
SIGNATURE
DATE SIGNED
Due and payable on or before the 20th day of each of the months of April, July, October, and January, reflecting the previous quarter's receipts.

Mail form and check (payable to City of Danville) to:

Commissioner of the Revenue
P.O. Box 480
Danville, VA 24543

The tax collected shall be deemed to be held in trust until such time tax is due and payable to the City of Danville, as prescribed by law.
Should be Empty:

Short Term Rental Tax Quarterly Report (1% Rental Tax)