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DUVAL COUNTY PUBLIC SERVICE TAX RETURN
MICHAEL CORRIGAN, TAX COLLECTOR
231 E FORSYTH STREET SUITE 212 JACKSONVILLE, FL 32202-3370
PHONE: (904) 630-2022 FAX: (904) 630-7134
WEBSITE: www.coj.net/tc
ACCOUNT NUMBER:
BUSINESS NAME:
PHONE NUMBER:
PERIOD:
DUE DATE:
File and pay on or before the 20th day of each month following collection.
Failure to do so will result in penalty
percent
per
month,
not
to
exceed
a
total
penalty
of
twenty-five
percent plus interest of one percent per month of the delinquent tax, except that in no event will the penalty be less than $ 15.00.
assessment
of
five
This return is subject to audit by the Tax Collector Duval County, Florida.
DUVAL COUNTY PUBLIC SERVICE TAX RETURN
MICHAEL CORRIGAN, TAX COLLECTOR
231 E FORSYTH STREET SUITE 212 JACKSONVILLE, FL 32202-3370
FUEL OIL DEALERS
GROSS GALLONS
LESS EXEMPT GALLONS
TAXABLE GALLONS
ACCOUNT NUMBER:
BUSINESS NAME:
TAX DUE ( 4 CENTS PER GALLON)
PHONE NUMBER:
ALL OTHER DEALERS
PERIOD:
GROSS SALES
LESS EXEMPT SALES
DATE DUE:
TAXABLE SALES
TAX DUE (10% OF SALES)
ADJUSTMENTS (ATTACH EXPLANATION)
TAX DUE
PLEASE MAIL OR BRING THIS NOTICE RECEIPT WITH YOUR REMITTANCE
MAKE CHECKS PAYABLE TO MICHAEL CORRIGAN, TAX COLLECTOR
SIGNATURE________________________________________________ PRINTED NAME _______________________________________