Occupational Tax Form - City of Bessemer, Alabama

This fillable "Occupational Tax Form" is a document issued by the Alabama Department of Revenue specifically for Alabama residents.

Download the PDF by clicking the link below and complete it directly in your browser or through the Adobe Desktop application.

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City of Bessemer
Revenue Department
RD
1806 3
Avenue North
Bessemer, AL 35020-4999
PHONE: (205)424-4060 FAX: (205) 425-2820
OCCUPATIONAL TAX FORM
Tax ID#
Taxpayer Name: _____________________
Address____________________________
____________________________
Number of taxable employees _______
Quarter Ending________
1. TOTAL SALARIES, WAGES, COMMISSION AND OTHER COMPENSATION
$
Paid to all taxable employees (*)
2. LESS: Nontaxable items (compensation paid for services outside of Bessemer)
$
(Please attach letter of explanation)
3. TAXABLE EARNINGS (Item 1 minus Item 2)
$
4. ACTUAL WITHELD IN QUARTER AT 1%
$
5. INTEREST (1% per month)
$
6. PENALTY (10% of line 5, MINIMUM $3.00)
$
7. TOTAL (INCLUDING INTEREST AND PENALTY IF DUE)
$
*IF NO WAGES WERE PAID THIS MONTH MARK “NONE” AND RETURN FORM WITH A EXPLANATION
***MAKE CHECK OR MONEY ORDER PAYABLE TO THE CITY OF BESSEMER***
A QUARTERLY RETURN MUST BE FILED AND THE TAX PAID BY THE TWENTIETH DAY OF THE
FIRST MONTH AFTER THE END OF THE CALENDAR QUARTER.
Each employer of one or more persons must withhold an occupational tax at the rate of 1% from gross salaries,
wages, and commissions paid for work or services performed within the City of Bessemer. All employees are
subject to the license tax except domestic servants employed in private homes. An employer shall be liable to court
action for failure to file a return and/or to pay the tax or for filing fraudulent return.
QUARTER_______ YEAR_________
________________________________
SIGNATURE
________________________________
OFFICIAL TITLE
City of Bessemer
Revenue Department
RD
1806 3
Avenue North
Bessemer, AL 35020-4999
PHONE: (205)424-4060 FAX: (205) 425-2820
OCCUPATIONAL TAX FORM
Tax ID#
Taxpayer Name: _____________________
Address____________________________
____________________________
Number of taxable employees _______
Quarter Ending________
1. TOTAL SALARIES, WAGES, COMMISSION AND OTHER COMPENSATION
$
Paid to all taxable employees (*)
2. LESS: Nontaxable items (compensation paid for services outside of Bessemer)
$
(Please attach letter of explanation)
3. TAXABLE EARNINGS (Item 1 minus Item 2)
$
4. ACTUAL WITHELD IN QUARTER AT 1%
$
5. INTEREST (1% per month)
$
6. PENALTY (10% of line 5, MINIMUM $3.00)
$
7. TOTAL (INCLUDING INTEREST AND PENALTY IF DUE)
$
*IF NO WAGES WERE PAID THIS MONTH MARK “NONE” AND RETURN FORM WITH A EXPLANATION
***MAKE CHECK OR MONEY ORDER PAYABLE TO THE CITY OF BESSEMER***
A QUARTERLY RETURN MUST BE FILED AND THE TAX PAID BY THE TWENTIETH DAY OF THE
FIRST MONTH AFTER THE END OF THE CALENDAR QUARTER.
Each employer of one or more persons must withhold an occupational tax at the rate of 1% from gross salaries,
wages, and commissions paid for work or services performed within the City of Bessemer. All employees are
subject to the license tax except domestic servants employed in private homes. An employer shall be liable to court
action for failure to file a return and/or to pay the tax or for filing fraudulent return.
QUARTER_______ YEAR_________
________________________________
SIGNATURE
________________________________
OFFICIAL TITLE

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