Business Information
Please provide all the information you may have to assist in the investigation of this complaint.
Legal Business Name
:
Contact Person:
Doing Business As
:
Address:
City, State, Zip:
Business Phone No
:
Additional
Phone No:
Business Website:
Permit No. (if known)
:
Nature of the business:
Evidence of Evasion
Please provide details that you have of the evasion, use additional sheets if necessary.
Tax Type(s) being evaded:
□
Sales/Use
□
Liquor
□
Tobacco
□
Vehicle
□
Tire
□
MBT
□
LET
Is there supporting documentation?
If yes, please see instructions
:
□ Yes □ No
Are there others who c
an
corroborate the evasion? :
□ Yes □ No
If Yes, please provide their name(s)
and any contact information you have:
Vehicle/Lic. Plate # & State if known:
Estimated dollar amount
:
Time Frame:
Please describe the evasion
and how it was discovered:
Your Information
Optional, please see instructions.
Name:
Address:
City, State, Zip:
May we contact you? :
Yes No
Contact Phone No.:
Submit this form electronically, or print and forward with any additional documentation to:
Nevada Department of Taxation Investigations, 700 E. Warm Springs Rd., Suite 200, Las Vegas, NV 89119.
E-mail with any attachments to investigations@tax.state.nv.us or click on the submit button below.
NEVADA DEPT OF TAXATION
TAX EVASION TIP
For Dept. Use Only: TID _______________
Prev. Audit: Yes No Thru ___________
Assigned to: _________________________
Print
Submit Form
TAX EVASION TIP FORM INSTRUCTIONS:
The Department will make every effort to protect your identity from disclosure; however, we cannot guarantee confidentiality since
disclosure may be required to those persons during the investigation whom need the information to do their job or in the course of
corrective action, or where Nevada laws authorize disclosure.
Some members of the public, who have made reports (anonymous, confidential or otherwise) on occasion, seek information on the
outcome of the case. Disclosure of such information must be refused as the information collected concerning the administration or
collection of any tax, fee, assessment, or other amount required by law is deemed confidential and privileged pursuant to NRS
360.255.
If you still wish to submit this form anonymously you will have to print it and send it via conventional mail. Please provide as much
information and documentation as possible, as we will not have any way to contact you.
Legal
Business Name:
The corporate name and/or legal name with the Secretary of State under which tax
returns are filed. It can also be the name of an individual as a sole proprietor.
Contact Person:
The owners name, bookkeeper, accountant or on-site manager.
Doing Business As
(DBA):
The trade name of the business, the name on the storefront, or the fictitious firm name
registered with the county in which the business resides.
Address, City, State,
Zip
The full address from which the business operates. It can be a residence or the
location of operations.
Phone numbers:
Any business, owner phone or mobile phone numbers related to this business.
Website address:
If you know the website URL address, please provide, it is helpful to the investigation.
Permit No. (if known)
The Nevada TID of the business or the IRS EIN tax reporting numbers.
Tax Type Being
Evaded:
Sales Tax
Permit
Every retailer that sells tangible personal property for storage or use or
consumption in Nevada shall register for a permit and collect applicable
sales tax and maintain adequate records. NRS 372.220, NRS 372.735, 740
Use Tax
Permit
Use Tax is the counterpart of Sales Tax. It is imposed on tangible
personal property used in Nevada on which Sales Tax has not been paid.
Any individual, business, corporation, or other entity can be liable for Use
Tax when Sales Tax was not collected by the seller. NRS 372.185.
Liquor
License
A State license is required for any business that is a wholesaler, supplier,
or manufacturer engaged in the re-sale of alcoholic beverages. NRS
369.180, NRS 369.040. Employees selling alcohol at retail establishments
must have an alcohol awareness card. NRS 369.630
Tobacco
Permits
A State Tobacco Retail Dealers License is required for all business that
conducts sales of cigarettes, cigars, or other tobacco products. State
Tobacco Wholesale Dealers Licenses(s) are required of all
manufacturers and wholesalers of cigarettes or other tobacco products.
NRS 370.080, NRS 370.445.
Vehicle
New Nevada residents must obtain vehicle registration within 30 days.
NRS 482.103, NRS 483.141.
MBT
Modified Business Tax is a quarterly payroll tax that is based on gross
W-2 wages.
NRS 363A & B
LET
A tax is imposed on live entertainment in a non-gaming facility with a
maximum occupancy of 200 or more and less than 7,500. Entities with
gaming are regulated by the NGB
. NRS 368A.110, NRS 368A.090.
Supporting
documentation:
Documentation to support the tax evasion allegations to be investigated. Attach them to
this form when you email it, send by fax or conventional mail.
Others who can
corroborate:
Contact information of anyone who may have direct knowledge of the evasion and are
willing to speak to an audit investigator in this matter.
Vehicle/Lic. Plate #
The license plate number for the offender, please list it along with the state of origin.
Estimated Dollar
Amount & Time Frame
Estimate of the amount of money you believe to be involved in this evasion, and the
dates in which the evasion occurred.
Describe the Evasion
The details of the tax evasion. If necessary please attach additional sheets and any
accompanying documentation you may have.
