LEASING OR RENTAL TAX
                                                                                                MONTHLY RETURN
                                                                                                                            MONTH COVERED BY THIS REPORT
                                                                                                                     OR 
                                                                                                                            PERIOD COVERED BY THIS REPORT
                                          www.cityofmobile.org/html/departments/revenuewww.cityofmobile.org/revenue3    From:                                        To:
CITY OF MOBILE  •  DEPARTMENT 1519  •  P.O. BOX 11407  •  BIRMINGHAM, AL 35246-1519  •  251-208-7462City of Mobile • P.O. Box 2745 • Mobile, AL 36652-2745 • Phone (251) 208-7461
                               FIGURES MAY BE ROUNDED TO NEAREST DOLLAR

                       NOTE: ENTER -
                       Gross receipts from Leasing and/or Renting of tangible
                       personal property from, within and/or into the City of Mobile
                       and from, within and/or into the Police Jurisdiction.                                            $

                       LEASING AND/OR RENTAL RECEIPTS                                                                CITY - 5%          P.J. - 2.5%
1. GROSS RECEIPTS from leasing and/or renting of tangible personal property into
   and within the City of Mobile and/or its Police Jurisdiction.                                                     $                      $
2. Total collections made during month on credit leases previously claimed as
   deductions.
3. Gross Receipts from leasing and/or renting of tangible personal property previously
   deducted as being leased for re-lease but returned for use of secondary lessor.

4. TOTAL OF 1, 2, & 3

   (A)    leases for re-leasing

   (B)    taxable credit leases made during current month not collected.

5. TOTAL OF 4A AND 4B
6. Amount Remaining as Measure of tax
   (Line 4 Minus Line 5 - each column)
7. Leasing or Rental Tax Due - Line 6 X
   applicable rate at top of each column
8. ________% Penalty - Each Col. (See Below*)

9. TOTAL EACH COL.                                                                                                   $                      $

                       10. Total Payment Enclosed With This Return:                                                                     $

Please     Account Number:              -                                                                     *PENALTY OF  5%  PER  MONTH  WHEN
Correct
Address if                                                                                                    PAID  AFTER  THE  20TH  OF  MONTH 
Changed                                                                                                       FOLLOWING THE PERIOD COVERED.
                                                                                                              This  report  including  accompanying  schedules  or
                                                                                                              statements, has  been  examined  by  me  and  is  to  the
                                                                                                              best  of  my  knowledge  and  belief, a  true  and 
________________   __________________________________________   _______________________________               complete report made in good faith for the period stated.
Date                   Signature                                                           Title
                                                                                                                                                                        REV. 5/11/2010REV. 9/3/2008