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Pari-Mutuel Wagering Tax NGC-PMT-1 - Nevada
| Pari-Mutuel Wagering Tax Form. This is a Nevada form and can be used in Tax And License Division Nevada Gaming Commission And State Gaming Contol Board Statewide . |
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NGC-PMT-1 (Rev 08-16-11) NEVADA GAMING COMMISSION (Used for Horse Races at County Fairs) PARI-MUTUEL WAGERING TAX This report, together with your remittance payable to the order of the Nevada Gaming Commission, is required to be filed NOT LATER THAN covering the preceding race day(s). Account No., Name, Address, Zip Code For Office Use Only Check No. ____________________ Batch No. ____________________ Entry Date ____________________ Please Correct as Necessary COVERING THE MEETS HELD ON: PAID ATTENDANCE......................................................................................... ________________ TOTAL NUMBER OF WAGERS.......................................................................... ________________ TOTAL NUMBER OF RACES............................................................................. ________________ TOTAL AMOUNT PAID TO WINNERS ................................................................. $_______________ AMOUNT OF BREAKAGE................................................................................. $_______________ AMOUNT OF UNPAID WINNERS........................................................................ $_______________ TOTAL DOLLAR AMOUNT RETAINED AS COMMISSIONS..................................... $_______________ (Not to exceed 20% of total amount handled) TAX COMPUTATION (per NRS 466.125(2)) 1. TOTAL AMOUNT OF PARI-MUTUEL WAGERS................................................ $_______________ 2. REMITTANCE DUE........................................................................................... $_______________ (1% of total amount shown on line 1) Please make remittance payable to: NEVADA GAMING COMMISSION Return to the State Gaming Control Board, PO Box 8004, Carson City, NV 89702-8004 Pursuant to NRS 353.1467, payments made to the State, in the aggregate, that amount to $10,000.00 or more must be sent electronically. I, , certify and declare under the penalties of perjury that I am the of the organization named above; that this is a true, correct and complete report to the best of my knowledge, information, and belief. Dated , Signed Phone Number: American LegalNet, Inc. www.FormsWorkFlow.com Person to contact regarding this report: RETURN THE ORIGINAL AND MAKE DUPLICATE COPY FOR YOUR RECORDS
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