DORES ACH COLLECTION SERVICES Addendum Records ADDENDUM A

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1 DORES ACH COLLECTION SERVICES Addendum Records New Jersey Division of Revenue and Enterprise Services CCD+/ Addendum Record ADDENDU A Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 T (Tax) 05 Amount N2 1/10 $$$$$$$$cc 06 Not d 07 Not d 08 Not used 09 Not d 10 Name Control 4/4 XXXX Payment (04120): Sales and Tax - Quarterly Return Payment Return Period End Date: September 30, 2017 Amount Due: $23, *B *04120*030930*T* *****SIT A DORES ACH RFP 2018 Page 1

2 CCD+/ Addendum Record ADDENDU B Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 T (Tax) 05 Tentative Tax N2 1/10 $$$$$$$$cc 06 Amount O ID 1/1 T (tax) 07 Installment Payment C N2 1/10 $$$$$$$$cc 08 Amount O ID 1/1 C (Credit) 09 Credits C N2 1/10 $$$$$$$$cc 10 Name Control 4/4 XXXX Payment (02301): Corporation Business Tax-Request for Extension Return Period End Date: Fiscal Year Ending October 31, 2017 Tentative Tax: $40, Installment Payment: $0.00 (None) Credits: $10, *B *0231*031031*T* *T*000*C* *SIT\ Special Note: This is a calculated payment based on Tentative Tax less Credits (05-09). B DORES ACH RFP 2018 Page 2

3 CCD+/ Addendum Record ADDENDU C Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 T (Tax) 05 New York Amount N2 1/10 $$$$$$$$cc 06 Amount ID 1/1 T (Tax) 07 New Jersey Amount N2 1/10 $$$$$$$$cc 08 Not d 09 Not d 10 Name Control 4/4 XXXX Payment (04112): Interstate Sales Tax NY/NJ onthly Remittance Payment Return Period End Date: July 31, 2017 New York Amount: $14, New Jersey Amount: $61, *B *04112*980731*T* *T* ***SIT\ C DORES ACH RFP 2018 Page 3

4 CCD+/ Addendum Record ADDENDU D Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 T (Tax) 05 Atlantic City Amount N2 1/10 $$$$$$$$cc 06 Amount ID 1/1 T (Tax) 07 New Jersey Amount N2 1/10 $$$$$$$$cc 08 Amount ID 1/1 T (Tax) 09 Promo Amount N2 1/10 $$$$$$$$cc 10 Name Control 4/4 XXXX Payment (04200): Atlantic City Luxury Sales Tax Payment Return Period End Date: November 30, 2017 Atlantic City Amount: $2, New Jersey Amount: $211, Promo Amount: $12, *B *04200*981130*T*215599*T* *T* *SIT\ D DORES ACH RFP 2018 Page 4

5 CCD+/ Addendum Record ADDENDU E Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 T (Tax) 05 Liability Amount N2 1/10 $$$$$$$$cc 06 Amount O ID 1/1 P (Penalty) 07 Penalty Amount C N2 1/10 $$$$$$$$cc 08 Amount O ID 1/1 I (Interest) 09 Interest Amount C N2 1/10 $$$$$$$$cc 10 Name Control 4/4 XXXX Payment (04110): Sales and Tax-onthly Remittance Payment Return Period End Date: September 30, 2017 Liability: $2, Penalty: $0.00 Interest: $50.00 *B *04110*980930*T*213948***I*5000*SIT\ E DORES ACH RFP 2018 Page 5

6 CCD+/ Addendum Record ADDENDU F Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 T (Tax) % Amount N2 1/10 $$$$$$$$cc 06 Amount ID 1/1 T (Tax) 07 7% Amount N2 1/10 $$$$$$$$cc 08 Not d 09 Not d 10 Name Control 4/4 XXXX Payment (04800): Urban Enterprise Zone Sales Tax Payment Return Period End Date: December 31, % Amount: $31, % Amount: $194, *B *04800*981231*T* *T* ***SIT\ F DORES ACH RFP 2018 Page 6

7 CCD+/ Addendum Record ADDENDU G Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 T (Tax) 05 Tax Withheld N2 1/10 $$$$$$$$cc 06 Amount O ID 1/1 P (Penalty) 07 Penalty Amount C N2 1/10 $$$$$$$$cc 08 Amount O ID 1/1 I (Interest) 09 Interest Amount C N2 1/10 $$$$$$$$cc 10 Name Control 4/4 XXXX Payment (01170): Employer Gross Income Tax - Weekly Withholding Payment Return Period End Date: February 7, 2017 Tax Withheld: $2, Penalty: $45.93 Interest: $50.00 *B *01170*980207*T*213948*P*4593*I*5000*SIT\ G DORES ACH RFP 2018 Page 7

8 New Jersey Division of Revenue and Enterprise Services CCD+/ Addendum Record ADDENDU H Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 T (Tax) 05 2% Amount N2 1/10 $$$$$$$$cc 06 Amount ID 1/1 T (Tax) 07 6% Amount N2 1/10 $$$$$$$$cc 08 Not d 09 Not d 10 Name Control 4/4 XXXX Payment (07500): Cape ay Tourism Improvement and Development - Payment Return Period End Date: December 31, % Amount: $31, % Amount: $194, *B *07500*981231*T* *T* ***SIT\ H DORES ACH RFP 2018 Page 8

9 CCD+/ Addendum Record ADDENDU I Return Period End Date DT 6/6 YYDD 04 Amount ID 1/1 05 Amount N2 1/10 $$$$$$$$cc 06 Invoice Number ID 9/9 XXXXXXXXX 07 Filler N 2/ Not d 09 Not d 10 Name Control 4/4 XXXX Payment (07500): Pesticides Pesticide Dealer Period End Date: June 30, 2017 Amount: $ Invoice Number: *B *50021*000630*T*39527* *00**SIT\ I DORES ACH RFP 2018 Page 9

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