BUSINESS TAX RENEWAL FORM – 22001166 RENEW ONLINE

Tax Incentives & Overpayment
Mail renewal form and payment to:
CITY OF LOS ANGELES
OFFICE OF FINANCE
P.O. Box 513996
Los Angeles, CA 90051-3996
BUSINESS TAX RENEWAL FORM – 2
2001166
RENEW ONLINE!
DELINQUENT AFTER
finance.lacity.org
II.
February 29, 2016
III.
Tax Worksheet
1. Small Business Exemption - Enter the total of your worldwide gross
receipts here: $____________________ and enter your in City gross
receipts in Column D (Basis for Tax).
2. Creative Activities Exemption: Check this box only if the
worldwide gross receipts attributable to “Creative Activities”
are $300,000 or less. Enter the total gross receipts from
Creative Activities inside the City of Los Angeles
$____________________ and enter ‘0’ in Column D (Basis for Tax).
3. Application of Overpayment: Check this box only if you
have an overpayment that you want to apply to your 2016
renewal. Please note that an overpayment cannot be applied
if the original payment date was over three years ago. If
applicable enter the overpayment amount
$____________________
(Deduct this amount from your Total Amount Due on Line 17)
For a Renewal Instruction Sheet, please visit our website or one of our Branch Offices.
Col. A
Col. B
Col. C
Col. D
Col. E
Col. F
Col. G
Col. H
Business Activity
Fund
Class
Primary
Class
Basis
For Tax
Tax
Rate
Tax
Computation
Back
Tax
Tax Due
Multiply Column:
(D x E)
- Refer to
Instructions
- Refer to
Instructions
4.
5.
6.
7.
8.
9.
10.
Add Columns:
(F + G)
.00
.00
.00
.00
.00
.00
.00
11.
Late Payment
Add Lines 4 through 11 in Column H. Enter result here.
N/A
Interest (If paid after February 29, 2016) - See Instruction Sheet
Penalty (If paid after February 29, 2016) - See Instruction Sheet
17.
Add Lines 12 through 16. Enter result here.
I DECLARE, UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT TO THE BEST OF
MY KNOWLEDGE THE INFORMATION PROVIDED IN THIS RENEWAL IS TRUE, CORRECT AND COMPLETE.
18.
Signature:
Print Name:
19.
Title:
Phone No.:
)
20.
Date:
__________
Email:
21.
Payment Type:
Check
#
daytime phone #
ext. if any
_________________________________
Money Order
Account #:
ACH
For your security, credit card payments are not accepted via mail. To pay via
credit card please use our online services or visit one of our public counters.
Please note that all Credit or Debit Card payments will be assessed a fee
equal to 2.7% of the payment amount.
22.
RETURN CHECK FEE
Please note that if a payment is rejected by the bank, a $35 fee will be
assessed along with any applicable interest and penalty.
I.
Payment Info
(
area code
All payments of $50,000 or more must be made electronically via Automated Clearing
House (ACH) through your bank. See instruction sheet for further information.
MAKE CHECK PAYABLE TO: Office of Finance City of Los Angeles. Please
write your account number on your check. Checks and money orders must be drawn
on United States banks only. NO SPLIT PAYMENTS.
V.
N/A
14.
Taxpayer Information
IV.
Certifications
Total Amount Due
12.
13.
15.
16.
GO
GREEN
Enroll in our paperless statement
program at finance.lacity.org
Change of Information: Check this box if there are any
changes regarding your taxpayer information. Record the
changes on the Information Update section (back of this
form).
PLEASE MAKE A COPY FOR YOUR RECORDS
Form 1000A (Blank)
ONLY FILL IN LETTERS ‘A - H’ IF YOU HAVE
CHANGES ON YOUR ACCOUNT
Account #:
NOTE:
B.
Name:
Tax Registration Certificates are not transferable. If your business is sold or transferred to another
entity or you purchase a business, a new Tax Registration Certificate is required. If you have moved
out of the City of Los Angeles, but continue to solicit or promote business activities within the City of
Los Angeles for seven or more days a year, you are still required to file a business tax renewal.
Effective:
Doing Business As (DBA)
Effective:
Mailing Address
City:
C.
Effective:
D.
(
Effective:
City:
E.
F.
G.
/
/
/
Zip:
State:
NO (Check one)
Rental Property Sold
Effective:
Entire Business(es) Sold or Discontinued
Effective:
Individual Business Activity Sold or Discontinued
Effective:
/
/
/
/
/
/
Fund/Class(es)
Fiscal year reporting START – fiscal year beginning:
The Los Angeles Municipal Code requires you to provide a list of all out-of-city vendors and subcontractors that meet the
following criteria: generated total invoices/billings to your business of $500,000 or more during your last complete business
year AND physically enter the city of Los Angeles seven (7) or more times a year. Provide this information below.
If you are an owner, lessor or sublessor, of office and/or commercial space in the City of Los Angeles, The Los Angeles
Municipal Code requires that you provide the Office of Finance the following information regarding your commercial tenants.
NAME
COMPLETE ADDRESS including SUITE NUMBER
PHONE NO.
INVOICED AMOUNT / RENTAL
VII.
Vendor / Subcontractor / Commercial Tenant Listing
H.
/
)
Business Address:
Is this a residential address? YES
/
/
NO (Check one)
Legal Name Change
New Telephone Number:
/
/
Zip:
State:
Is this a residential address? YES
VI.
Information Update
A.
2016
(PLEASE USE ADDITIONAL SHEETS IF NECESSARY)
Non-financial information such as name, business address, etc., contained in your City of Los Angeles tax and permit
records, is subject to disclosure under provisions of the California Public Records Act, Government Code Section 6250
et seq. If you are engaged in a home-based business, your residential information is also subject to public disclosure if
that location is utilized for business purposes.
Form 1000A (Blank)