MEALSTAX REGISTRATION Name ofseller Trade Name Location Mailing Address I the above named prospective seller ofmeals, licensed to do business in the City fCovington, Virginia, on this date register for collection of meals tax. This tax to be reported each calendar month showing amount of charges collected for meals and the amount oftax on the appropriate forms provided by the City. This information shall bc submittcd to the Commissioner of Revenue, P.0. Drawer 58, Covington, VA 24426, on or before the 20th day of the calendar month following the month. being reported. Each report shall be accompanied by a remittance ofthe amount oftax due, made payable to the City Treasurer. Ifany person whose duty it isto do sO, shall fail or refuse to make the report or remit the tax required within the Lime and in the amount required, there shall be added to the tax by the Commissioner of Revenue a penalty in the amount of5%:ofthe tax, ora minimum or $2.00, ifsuch failure is for not more than 30 days duration. and thereafter, interest shall be payable on such overdue tax in the amount of12% per annum. Signed Title Date