Ozark Advertising & Promotions Tax Form

OZARK ADVERTISING AND PROMOTION COMMISSION

1% Hamburger Tax
GROSS RECEIPTS TAX MONTHLY REPORT
Business Name:
Address:
For the month of:
(Each month must be reported separately. Report must be filed even if no tax is due.)
Taxable Gross Receipts Amount
Tax (1% of gross)
Less 2% of tax (if paid by 20th)
"0" if not applicable
Total
5% penalty per month (over 30 days late)
"0" if not applicable
TOTAL TAX DUE
Pay Online

OR

Make check payable and mail with payment to:

Ozark Advertising & Promotion Commission
PO Box 1028
Ozark, AR
479-667-2525
I hereby state, avow and affirm that the statements herein are full, true and correct as required by provisions of Arkansas Gross Receipts Tax Law, Act 626 of 1989 and City Ordinance #1991-4, and such regulations promulgated thereunder by the Ozark Advertising & Promotion Commission.
Date Prepared

MonthDayYear
Date
Signature
Should be Empty:

OZARK ADVERTISING AND PROMOTION COMMISSION