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Rhode Island Free Printable 2013 HCP-64_Layout 1 for 2024 Rhode Island Outpatient Health Care Facility Surcharge Return

Form HCP-64 is obsolete, and is no longer supported by the Rhode Island Department of Revenue.

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Outpatient Health Care Facility Surcharge Return
2013 HCP-64_Layout 1

State of Rhode Island and Providence Plantations Form HCP-64 Outpatient Health Care Facility Surcharge Return Name Federal employer identification number Address For the month ending: MM/DD/YYYY Address 2 City, town or post office State E-mail address ZIP code Calculation of Amount Due: 1 Net patient services revenue received..................................................................................................... 1 2 Outpatient health care facility surcharge. Multiply line 1 times 2% (0.02).............................................. 2 3 Interest calculated at 1.5% per month. See instructions.......................... 3 4 Penalty calculated at 10%. See instructions ........................................... 4 5 Total interest and penalty amount. Add lines 3 and 4............................................................................. 5 6 TOTAL AMOUNT DUE. Add lines 2 and 5.............................................................................................. 6 INSTRUCTIONS Line 1: Net Patient Services Revenue Received - Enter the amount of all monies and other consideration received for patient care services for the month being reported on this return. Line 4: Penalty - If remitting after the due date, multiply line 2 time 10% (0.10). Penalty is calculated at 10% of the surcharge due. Line 5: Total Interest and Penalty Amount - Add lines 3 and 4. Line 2: Outpatient Health Care Facility Surcharge - Multiply line 1 times 2.0% (0.02) Line 6: Total Amount Due - Add lines 2 and 5. Line 3: Interest - If remitting after the due date, multiply line 2 times 1.5% (0.015) times the number of months late. Interest is calculated from the due date of the return to the date of remittance at a rate of 18% per annum. PAYMENTS MUST BE MADE BY ELECTRONIC FUNDS TRANSFER (EFT). For more information, visit www.tax.ri.gov/contact/ . Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, it is true, accurate and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Authorized officer signature Print name Date Telephone number Paid preparer signature Paid preparer address Print name City, town or post office May the Division of Taxation contact your preparer? YES Date State Telephone number ZIP code Revised 09/2013 PTIN Key #76
Extracted from PDF file 2020-rhode-island-form-hcp-64.pdf, last modified October 2013

More about the Rhode Island Form HCP-64 Corporate Income Tax

This form is due on or before 25th day of the following month of outpatient care.

We last updated the Outpatient Health Care Facility Surcharge Return in April 2021, and the latest form we have available is for tax year 2020. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Rhode Island Division of Taxation. You can print other Rhode Island tax forms here.

Other Rhode Island Corporate Income Tax Forms:

TaxFormFinder has an additional 78 Rhode Island income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 7004 Extension Request
Form 1120V Payment Voucher
Form 1065V Partnership Income Tax Payment Voucher
Form 1065 Partnership Income Tax Return to be filed by LLCs, LLPs, LPs and Partnerships
Form BUS-EXT Business Tax Automatic Extension Request - For T-72 and T-74

Download all RI tax forms View all 79 Rhode Island Income Tax Forms


Form Sources:

Rhode Island usually releases forms for the current tax year between January and April. We last updated Rhode Island Form HCP-64 from the Division of Taxation in April 2021.

Show Sources >

About the Corporate Income Tax

The IRS and most states require corporations to file an income tax return, with the exact filing requirements depending on the type of company.

Sole proprietorships or disregarded entities like LLCs are filed on Schedule C (or the state equivalent) of the owner's personal income tax return, flow-through entities like S Corporations or Partnerships are generally required to file an informational return equivilent to the IRS Form 1120S or Form 1065, and full corporations must file the equivalent of federal Form 1120 (and, unlike flow-through corporations, are often subject to a corporate tax liability).

Additional forms are available for a wide variety of specific entities and transactions including fiduciaries, nonprofits, and companies involved in other specific types of business.

Historical Past-Year Versions of Rhode Island Form HCP-64

We have a total of eight past-year versions of Form HCP-64 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2020 Form HCP-64

2013 HCP-64_Layout 1

2019 Form HCP-64

2013 HCP-64_Layout 1

2018 Form HCP-64

2013 HCP-64_Layout 1

2016 Form HCP-64

2013 HCP-64_Layout 1

2015 Form HCP-64

2013 HCP-64_Layout 1

Outpatient Health Care Facility Surcharge Return - Due on or before 25th day of the following month 2014 Form HCP-64

2013 HCP-64_Layout 1


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