Exhibitors Herald (Jun-Dec 1917)

Record Details:

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NOTE: Below is printed a blank form which exhibitors may use in keeping records upon which to base tax reports on admissions. It is essential that a daily record be kept in order that the Government may be able to obtain the information it requires in each case. This form has been sanctioned by officials of the Internal Revenue Department. NAME OF THEATRE ADDRESS Month Ending REVENUE TAX REPORT ON ADMISSIONS _ _ OWNER CITY. STATE ... 1 ! 1 Children Date 5c 10c 15c 20c 25c j Passes 1 i J 2 1 -~ — 1 1 ! 1 -m id — 7^ 1 1 ■ .' . $ 1 — i — 10 1 -. e:: . — 1 n >? , ,™„.. is. , ■ A u. i _ _.. i 15 i 16 1 ■ -r— 19 — — i ... 20 21 :::::::=ii:::i= 22 23 . 24 25 — I 26 27 28 29 i 30 31 RECAPITULATION AMOUNT REVENUE TAX ADMISSIONS . at Scat 10c... at 15c at 20c ... at 25c None J Passes Children Total We hereby certify that < bove report is correct to the best of our knowledge. _ «_Mgr. -Cashier. Certified check covering the above specified War \evenue Tax was mailed by me this day of.. Collector of Internal Revenue for the _ _ District of 1917. to the -Mgr. Additional copies of this form will be supplied FREE to all exhibitors addressing a request for same to EXHIBITORS HERALD, 203 South Dearborn St., Chicago. 10