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Name of Business   | email   |  |  | Business Phone   |  |\n| --- | --- | --- | --- | --- | --- |\n| Street  \u003Cbr>Business Location   |  | City   | State   |  | Zip   |\n| Mailing Address  \u003Cbr>Street   |  | City   | State   |  | Zip   |\n\nReport for1st0an March)(Apr-June)3rd        4th      (July-Sept)(Oct-Dec)  \n\n| CLASSIFICATION   | GROSS  \u003Cbr>RECEIPTS   | DEDUCT  \u003Cbr>cOST OF  \u003Cbr>PRIZES   | NET  \u003Cbr>RECEIPTS   | TAX RATE   | TOTAL  \u003Cbr>TAX  \u003Cbr>DUE   |\n| --- | --- | --- | --- | --- | --- |\n| BINGO or RAFFLE   |  |  | $0.00   | 5%   | $0.00   |\n| AMUSEMENT GAMES   |  |  | $0.00   | 2%   | $0.00   |\n| FUND RAISING EVENTS (Raffles)   |  |  | $0.00   | 10%   | $0.00   |\n| PULL TABS or PUNCH BOARDS  \u003Cbr>(as commercial stimulant)   |  |  | $0.00   | 5%   | $0.00   |\n| PULL TABS or PUNCH BOARDS  \u003Cbr>(as charitable or non profit organizations)   |  |  | $0.00   | 10%   | $0.00   |\n| SOCIAL CARD GAME   |  |  |  | 10%   | $0.00   |\n| PUBLIC CARD ROOM   |  |  |  | 10%   | $0.00   |\n| TOTAL DUE   | $0.00   | $0.00   | $0.00   |  | $0.00   |\n\nWASHINGTON STATE GAMBLING COMMISSIONLICENSE NO.  \nDATE EXPIRING                                                                                                                \n## CITY of YAKIMA-QUARTERLY GAMBLING TAX STATEMENT\n\nNotice:With your 2nd &4th Quarter Remittance,please attach a copy of your activity report filed with theWashington State Gambling Commission.For Auditing purposes,your payment cannot be processed withoutit.If you file in person,the City Treasury office will make a copy for you.  \nThis statement,together with a copy of the report filed with the Washington State Commission,MUST be filed with theCity Department of Finance on or before the 30th day of the month following the end of each quarterly period in whichdeclarant holds a State Gambling License and must be accompanied by the remittance for taxes accrued during suchperiod.  \nFailure to pay when due will require a PENALTY to be added to the tax due as provided in Section 5.49 of theCity of Yakima Municipal Code.  \nMake checks payable to  \n## City of Yakima TreasurerAccounts Receivable129 North 2nd StreetYakima WA98901\n\nSTATE OF WASHINGTONCOUNTY OF YAKIMA  \n                                              (Declarant),being first duly sworn on oath,deposes and says:that the above named declarant;has read the within and foregoing quarterlystatement,knows the contents thereof and believes the same to be true.  \n(Declarant)  \nSubscribed and sworn to before me this      day of_  \n                          \n## Notary Public in and for the State ofWashington,residing at","cbCaiis2PjzpVbGA","https://ap.wps.com/l/cbCaiis2PjzpVbGA","pdf",156438,"English","# DATE RECEIVED and AMOUNT REMITTED\n## Business identity and contact information\n## Report period and classification tax table\n## Filing notice, audit requirement, and penalties\n## Payment instructions and sworn declaration","[{\"question\":\"What information must be provided on the Quarterly Gambling Tax Statement?\",\"answer\":\"The form requires business name and contact details, plus DATE RECEIVED, AMOUNT REMITTED, and RECEIPTNUMBER, along with the quarterly tax totals.\"},{\"question\":\"How are gambling categories taxed on this form?\",\"answer\":\"Each category lists gross receipts, deductible cost of prizes (where applicable), net receipts, the specified tax rate, and the resulting TOTAL TAX DUE.\"},{\"question\":\"What must be attached with the 2nd and 4th quarter remittance?\",\"answer\":\"A copy of the activity report filed with the Washington State Gambling Commission must be attached.\"}]","Quarterly Gambling Tax Form - 9.17.20 | PDF",1789790005]