EFTA00300258.pdf

FORM 720 V.I. Print Form (REV. 03/2012) Government of the U. S. Virgin Islands Gross Receipts Monthly Tax Return BUREAU OF INTERNAL REVENUE (Use for filing receipts of more than $225.000 per year.) Employer Identification Number (EIN) Please Print or TAX MONTH Type Clearly 0 5 Social Security Number (SSN) Indicate Firm Type: Accounting Method: 20 1 5 Sole Proprietor v CASH Partnership ACCRUAL EXEMPTION CODE H M V Corporation (SEE REVERSE ) I.) GROSS RECEIPTS t. 567,525.00 2.) (minus) EXEMPTION (ex. Standard SS,000 or 59,000. Fishermen. EDC, lottery 2. commission. affordable housing. reverse osmosis. etc. -567,525.00 J 3.) TAXABLE RECEIPTS (line I minus line?) 3. 0.00 4.) TAX DUE (multiply line 3 by the narrate of 0.05 ors%) 4. 0.00 5.) UP FRONT GROSS RECEIPTS TAX WITHHELD 5. 6.) ADJUSTED TAX DUE (line 4 minus lines) 6. 0.00 7.) PENALTY (if payment is late, multiply line 6 by .05 or 5% per month, but not to 7. exceed 2.5%) R.) INTEREST (if payment is late, multiply line 6 by .01 or 1% per month) & 9.) (minus) CREDITS (overpayments) 9. F-- 10.) TOTAL AMOUNT DUE (add line 6, 7.8 minus line 9) 10. 0.00 Name Southern Trust Company, Inc. 11 ) Indicate Principal Business Activity Code: H 4 I 6 plirq D/B/A (SEE REVERSE ) 12.) Telephone Number Mailing Address 6100 Red Hook Quarter, B3 PLEASE REMIT BY DUE DATE TO: City State Zip Code BUREAU OF INTERNAL REVENUE St. Thomas V I 00802-1348 Sr. THOMAS, U.S.V.I. 00802 St CROIX, U.S.V.I. 00820 I DECLARE UNDER PENALTY OF PERJURY THAT THIS RETURN HAS BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS TRUE, CORRECT AND COMPLETE, PURSUANT TO TITLE 33 VIC SECTIONS 42 & 43. Print Name: Jeffrey Epstein Title: President (PRESIDENT, OWNER, Ell I Signature: Date: 06/29/15 FORM 720V1 (31x)12) EFTA00300258