Form RCT-111 Gross Receipts Tax (Grt) Report - Telecommunications - Pennsylvania

Form RCT-111 or the "Gross Receipts Tax (grt) Report - Telecommunications" is a form issued by the Pennsylvania Department of Revenue.

The form was last revised in July 1, 2017 and is available for digital filing. Download an up-to-date Form RCT-111 in PDF-format down below or look it up on the Pennsylvania Department of Revenue Forms website.

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FILL IN FORM USING ALL CAPS.DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY.
1110017105
OFFICIAL USE ONLY
rct-111
Date Received (Official Use Only)
Page 1 of 7
07-17 (FI)
groSS receIPtS taX (grt) rePort
c
teLecoMMUNIcatIoNS
Tax Year Begin:
START
Revenue ID
Federal ID (FEIN)
Parent Corporation (FEIN)
Tax Year End:
_ _
12 31 20
Due Date: March 15
Please select correct letter in drop down
Taxpayer Name
Check to Indicate a Change of Address
Send All Correspondence to the Preparer
First Line of Address
Amended Report (Include REV-1175.)
First Report
Second Line of Address
Payment Made Electronically
City
State
ZIP
Final Report (See Instructions.)
Phone
Out of Existence Date:
Email
USe whoLe DoLLarS oNLy
1a. Intrastate Gross Receipts Tax Liability (Page 2, Line 26, Column A)
1a.
1b. Interstate Gross Receipts Tax Liability (Page 2, Line 26, Column B)
1b.
1c. Mobile Gross Receipts Tax Liability (Page 2, Line 26, Column C)
1c.
1d. Total Gross Receipts Tax Liability (Line 1a plus Line 1b plus Line 1c)
1d.
2.
Total Estimated Payments
2.
3.
Total Payments Carried Forward From Prior Year Return
3.
4.
Total “Restricted” Tax Credits
4.
5.
Total Credit: (Line 2 plus Line 3 plus Line 4)
5.
6.
Tax Due: (If Line 1d is more than Line 5, enter the difference here.)
6.
7.
Remittance
7.
8.
Overpayment: (If Line 5 is more than Line 1d, enter the difference here.)
8.
9.
Refund: (Amount of Line 8 to be refunded after offsetting all unpaid liabilities)
9.
10. Transfer: (Amount of Line 8 to be credited to the next tax year after offsetting
10.
all unpaid liabilities)
1110017105
corporate officer Information:
Social Security
Number of Officer
Officer Last Name
Officer First Name
Phone
Title of Officer
Email
I affirm under penalties prescribed by law, this report, including any accompanying schedules and statements, has been examined by me and to the best of my
knowledge and belief is a true, correct and complete report. If this report is an amended report, the taxpayer hereby consents to the extension of the assessment
period for this tax year to one year from the date of filing of this amended report or three years from the filing of the original report, whichever period last expires,
and agrees to retain all required records pertaining to that tax and tax period until the end of the extended assessment period, regardless of any statutory
provision providing for a shorter period of retention. For purposes of this extension, an original report filed before the due date is deemed filed on the due date.
I am authorized to execute this consent to the extension of the assessment period.
Signature of officer
Date
Signature of Officer – Please sign after printing
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FILL IN FORM USING ALL CAPS.DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY.
1110017105
OFFICIAL USE ONLY
rct-111
Date Received (Official Use Only)
Page 1 of 7
07-17 (FI)
groSS receIPtS taX (grt) rePort
c
teLecoMMUNIcatIoNS
Tax Year Begin:
START
Revenue ID
Federal ID (FEIN)
Parent Corporation (FEIN)
Tax Year End:
_ _
12 31 20
Due Date: March 15
Please select correct letter in drop down
Taxpayer Name
Check to Indicate a Change of Address
Send All Correspondence to the Preparer
First Line of Address
Amended Report (Include REV-1175.)
First Report
Second Line of Address
Payment Made Electronically
City
State
ZIP
Final Report (See Instructions.)
Phone
Out of Existence Date:
Email
USe whoLe DoLLarS oNLy
1a. Intrastate Gross Receipts Tax Liability (Page 2, Line 26, Column A)
1a.
1b. Interstate Gross Receipts Tax Liability (Page 2, Line 26, Column B)
1b.
1c. Mobile Gross Receipts Tax Liability (Page 2, Line 26, Column C)
1c.
1d. Total Gross Receipts Tax Liability (Line 1a plus Line 1b plus Line 1c)
1d.
2.
Total Estimated Payments
2.
3.
Total Payments Carried Forward From Prior Year Return
3.
4.
Total “Restricted” Tax Credits
4.
5.
Total Credit: (Line 2 plus Line 3 plus Line 4)
5.
6.
Tax Due: (If Line 1d is more than Line 5, enter the difference here.)
6.
7.
Remittance
7.
8.
Overpayment: (If Line 5 is more than Line 1d, enter the difference here.)
8.
9.
Refund: (Amount of Line 8 to be refunded after offsetting all unpaid liabilities)
9.
10. Transfer: (Amount of Line 8 to be credited to the next tax year after offsetting
10.
all unpaid liabilities)
1110017105
corporate officer Information:
Social Security
Number of Officer
Officer Last Name
Officer First Name
Phone
Title of Officer
Email
I affirm under penalties prescribed by law, this report, including any accompanying schedules and statements, has been examined by me and to the best of my
knowledge and belief is a true, correct and complete report. If this report is an amended report, the taxpayer hereby consents to the extension of the assessment
period for this tax year to one year from the date of filing of this amended report or three years from the filing of the original report, whichever period last expires,
and agrees to retain all required records pertaining to that tax and tax period until the end of the extended assessment period, regardless of any statutory
provision providing for a shorter period of retention. For purposes of this extension, an original report filed before the due date is deemed filed on the due date.
I am authorized to execute this consent to the extension of the assessment period.
Signature of officer
Date
Signature of Officer – Please sign after printing
Reset Entire Form
RETURN TO TOP
NEXT PAGE
PRINT FORM
FILL IN FORM USING ALL CAPS.DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY.
1110017205
Revenue ID
rct-111
Page 2 of 7
07-17 (FI)
SoUrce of groSS receIPtS
Column A
Column B
Column C
PA TAXABLE
PA TAXABLE
PA TAXABLE
c
USe whoLe DoLLarS oNLy
INTRASTATE
INTERSTATE
MOBILE
Local Network Service
1.
FCC-5000 – Basic Local Service (Class B Account)
2.
FCC 5001 – Basic Area (Class A Account)
3.
FCC 5002 – Optional Extended Area
(Class A Account)
4.
FCC 5003 – Cellular Mobile (Class A Account)
5.
FCC 5040 – Private Line (Class A Account)
6.
FCC 5060 – Other Basic Area (Class A Account)
Network access Service
7.
FCC 5081 – End User
8.
FCC 5082 – Switched Access
9.
FCC 5083 – Special Access
Long Distance Network Services
10. FCC 5100 – Long Distance Message
Miscellaneous – 5200
11. Transport and Termination of Local Telecom Traffic
12. Unbundled Network Elements
13. Private Mobile Telephone Services
14. Collections Overages
15. Charges Customer Checks Returned -
Nonpayment
16. Late Payment Charges
17. All Other Taxable Sources - Attach Schedule
18. FCC 5230 – Directory (Class A Account)
19. FCC 5280 – Nonregulated Operating Income
20. FCC 7100 – Other Operating Income
21. FCC 7300 – Nonoperating Income
22. All Other Nontaxable Sources – Attach Schedule
23. Total Taxable Receipts
(Sum of Line 1 through Line 22)
24. Tax (Line 23 times tax rate - See Instructions.)
25. Tax Credits (Applies to Interstate
and Mobile only)
26. Tax (Line 24 minus Line 25)
27. Source of Report Information (A=FCC, B=PUC, C=Federal Tax)
Preparer’s Information:
28. Accounting method for GRT (A=Accrual, B=Cash, C=Other)
Firm Name
Individual Preparer Name
Firm FEIN
Phone
Address
Email
City
Social Security Number
or PTIN
State
ZIP
1110017205
I affirm under penalties prescribed by law, this report, including any accompanying schedules and statements, has been prepared by me and to the best of
my knowledge and belief is a true, correct and complete report.
Signature of Preparer
Date
Signature of Preparer – Please sign after printing
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1110017305
rct-111
Page 3 of 7
07-17 (FI)
groSS receIPtS taX - teLecoMMUNIcatIoNS
c
Taxpayer Name
Revenue ID
Pa SaLeS for reSaLe eXeMPtIoN ScheDULe
12/31/20
for taX year:
USe whoLe DoLLarS oNLy
(a)
(B)
(c)
Name of
Pa Sales
Intrastate (11)
Interstate (12)
Mobile (13)
reseller
tax Number
feIN
gross receipts
gross receipts
gross receipts
(column a)
(column B)
(column c)
totals
1110017305
grand total (Sum of Columns A, B and C)
Notice to Taxpayer: Allowance of the Sales for Resale Exemption is contingent on the validation of
the listed entities’ subjectivity to gross receipts tax.
1110017305
1110017305
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rct-111
Page 4 of 7
Revenue ID
07-17 (FI)
1110017405
groSS receIPtS taX - teLecoMMUNIcatIoNS
Column 1
Column 2
Column 3
Total Gross
Receipts from Business
Adjustment for
Receipts
Conducted in
PA Bad Debts
Source of gross receipts
Everywhere
Other States
(Provide Details)
Local Network Service
1. FCC-5000 – Basic Local Service
(Class B Account)
2. FCC 5001 – Basic Area (Class A Account)
3. FCC 5002 – Optional Extended Area
(Class A Account)
4. FCC 5003 – Cellular Mobile (Class A Account)
5. FCC 5040 – Private Line (Class A Account)
6. FCC 5060 – Other Basic Area
(Class A Account)
Network access Service
7. FCC 5081 – End User
8. FCC 5082 – Switched Access
9. FCC 5083 – Special Access
Long Distance Network Services
10. FCC 5100 – Long Distance Message
Miscellaneous – 5200
11. Transport and Termination of Local Telecom Traffic
12. Unbundled Network Elements
13. Private Mobile Telephone Services
14. Collections Overages
15. Charges Customer Checks Returned -
Nonpayment
16. Late Payment Charges
17. All Other Taxable Sources (Attach Schedule.)
18. FCC 5230 – Directory (Class A Account)
19. FCC 5280 – Non-regulated Operating Income
20. FCC 7100 – Other Operating Income
21. FCC 7300 – Non-operating Income
22. All Other Non-taxable Sources (Attach Schedule.)
23. Total (Sum of Line 1 through Line 22)
1110017405
1110017405
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rct-111
Page 5 of 7
Revenue ID
07-17 (FI)
1110017505
groSS receIPtS taX - teLecoMMUNIcatIoNS
Column 4
Column 5
Column 6
Nontaxable PA
PA Sales for
PA Taxable
Receipts
Resale
Receipts
Source of gross receipts
(Provide Details)
Local Network Service
1. FCC-5000 – Basic Local Service
(Class B Account)
2. FCC 5001 – Basic Area (Class A Account)
3. FCC 5002 – Optional Extended Area
(Class A Account)
4. FCC 5003 – Cellular Mobile (Class A Account)
5. FCC 5040 – Private Line (Class A Account)
6. FCC 5060 – Other Basic Area
(Class A Account)
Network access Service
7. FCC 5081 – End User
8. FCC 5082 – Switched Access
9. FCC 5083 – Special Access
Long Distance Network Services
10. FCC 5100 – Long Distance Message
Miscellaneous – 5200
11. Transport and Termination of Local Telecom Traffic
12. Unbundled Network Elements
13. Private Mobile Telephone Services
14. Collections Overages
15. Charges Customer Checks Returned -
Nonpayment
16. Late Payment Charges
17. All Other Taxable Sources (Attach Schedule.)
18. FCC 5230 – Directory (Class A Account)
19. FCC 5280 – Non-regulated Operating Income
20. FCC 7100 – Other Operating Income
21. FCC 7300 – Non-operating Income
22. All Other Non-taxable Sources (Attach Schedule.)
23. Total (Sum of Line 1 through Line 22)
1110017505
1110017505
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Download Form RCT-111 Gross Receipts Tax (Grt) Report - Telecommunications - Pennsylvania

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