Tennessee Business Tax Return - Classification 5A

Business Tax Return - Classification 5A
County Business Tax Return Classification 5A BUS417
RV-R0012601

TENNESSEE DEPARTMENT OF REVENUE
BUSINESS TAX RETURN
Filing Period

BUS
417

Due Date

Business License No.

Account No.

FEIN/SSN/TIN

Location Address

FY END DATE

Make your check payable to Tennessee
Department of Revenue and mail to:
Tennessee Department of Revenue
Andrew Jackson State Office Building
500 Deaderick Street
Nashville, Tennessee 37242

Classification

5A
Name:

INTERNET (09-15)

Should you need assistance, please contact
the Taxpayer Services Division by calling our
statewide numbers: 1-800-342-1003 or (615)
253-0600.

_________________________________________________________

Address: _________________________________________________________
(Address to which returns should be mailed)

If this is an AMENDED RETURN,
please check the box at right

}

If this is a return for a CLOSED
business, please check the
box at right.

}

City: ________________________________ State: _____ Zip: __________

ROUND TO NEAREST DOLLAR

1. Total gross income of the business..................................................................................................... (1)

.00

2. Enter deductions from Schedule A, Line 18.....................................................................................

(2)

.00

3. Taxable income of the business (Subtract Line 2 from Line 1)........................................................... (3)

.00

4. Total business tax (Multiply Line 3 by .003. Enter result not to exceed $1,500. Minimum tax is $450.)......................

(4)

.00

5. Enter credit memo balance..................................................................................................................................

(5)

%
.00

6. Penalty (See instructions)...........................................................................................................................................

(6)

%
.00

7. Interest (

(7)

%
.00

(8)

%
.00

% per annum on taxes unpaid by the due date; see instructions)........................................................

8. Total amount due (Add Lines 4, 6, and 7; subtract Line 5)
(Make checks payable to the Tennessee Department of Revenue).............................................................

FOR OFFICE USE ONLY

I declare this is a true, complete, and accurate return to the best of my
knowledge.
SIGN
HERE
President or other Principal Officer, Partner or Proprietor
Date
SIGN
HERE

Tax Return Preparer and Title

41716500000000000000000000000000000000000000000000000000000000000000

Date

INTERNET (09-15)

Schedule A. Deductions from Gross Sales
1. Sales of services received by persons located in other states............................................................. (1)

.00

2. Returned merchandise when the sales price is refunded to the customer.............................................. (2)

.00

3. Sales in interstate commerce where the purchaser takes possession outside Tennessee for use or
consumption outside Tennessee....................................................................................................... (3)

.00

4. Cash discounts allowed and taken on sales....................................................................................... (4)

.00

5. Repossessions - The portion of the unpaid principal balance in excess of $500 due on tangible personal property repossessed from customers....................................................................................... (5)

.00

6. The amount allowed as trade-in value for any articles sold...................................................................

.00

(6)
7. Bad debts written off during the reporting period and eligible to be deducted for federal income tax
purposes......................................................................................................................................... (7)
8. Amounts paid by a contractor to a subcontractor holding either a business license or contractor's
license for performing activities described in Tenn. Code Ann. Section 67-4-708(4)(A). Must
(8)
complete Schedule B and file with the return......................................................................................

.00
.00

Federal and Tennessee privilege and excise taxes:
(Note: All deductions must have adequate records maintained to substantiate deductions claimed or they will be disallowed.)

9.
10.

Federal and Tennessee gasoline tax............................................................................................... (9)

.00

Federal and Tennessee motor fuel tax............................................................................................ (10)

.00

11. Federal and Tennessee tobacco tax on cigarettes............................................................................ (11)

.00

12. Federal and Tennessee tobacco tax on all other tobacco products....................................................

(12)

.00

13. Federal and Tennessee beer tax....................................................................................................

(13)

.00

14. Tennessee special tax on petroleum products........................................................

(14)

.00

15. Tennessee liquified gas tax for certain motor vehicles..............................................

(15)

.00

16. Tennessee beer wholesale tax.........................................................................................................

(16)

.00

17. Other deductions not taken elsewhere on the return........................................................................

(17)

.00

(Specify)

18. Total Deductions. Add Lines 1 through 17. Enter here and in Page 1, Line 2......................... (18)

.00