Nevada Medical Cannabis Tax Return — EXC-F079 (combo form+instructions)

# preamble

TID No:

# MEDICAL MARIJUANA TAX RETURN

Cultivator, Producer, & Dispensary For Department Use Only MAIL ORIGINAL TO: NEVADA DEPARTMENT OF TAXATION 3850 ARROWHEAD DRIVE CARSON CITY, NV 89706 Due on or before Date paid

# IF POSTMARKED AFTER DUE DATE, PENALTY AND INTEREST WILL

APPLY. If the business name or address has changed, please contact the Call Center at (866) 962-3707 as soon as possible to update your account with the Department.

MAKE CHECKS PAYABLE TO NEVADA DEPT OF TAXATION A RETURN MUST BE FILED EVEN IF

NO TAX LIABILITY EXISTS I HEREBY CERTIFY THAT THIS RETURN INCLUDING ANY ACCOMPANYING SCHEDULE AND

STATEMENTS HAS BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IS A TRUE, CORRECT AND COMPLETE RETURN. RETURN MUST BE SIGNED.

SIGNATURE OF TAXPAYER OR AUTHORIZED AGENT TITLE PHONE NUMBER (WITH AREA CODE) FEDERAL TAX ID NUMBER (EIN OR SSN) DATE

NEVADA DEPARTMENT OF TAXATION - Return for month ending

ENTER NAME OF PERSON SIGNING RETURN CULTIVATION FACILITY 1. TOTAL SALES MADE THIS PERIOD

PRODUCTION FACILITY 2. TOTAL SALES MADE THIS PERIOD

# MEDICAL MARIJUANA DISPENSARY

3. TOTAL SALES MADE THIS PERIOD 4. TOTAL COMBINED SALES MADE THIS PERIOD - (Line 1 + Line 2 + Line 3) 5. TOTAL CALCULATED TAX [Line 4 x 2% (0.02)] 8. 10. PREVIOUS DEBTS (Outstanding Liabilities as determined by the Department) 11. TOTAL AMOUNT DUE AND PAYABLE (Line 7+ Line 8 + Line 9 + Line 10) 12. AMOUNT PAID 6. 7. NET TAX DUE (Line 5 minus Line 6) PENALTY IF LATE (See Instructions) INTEREST IF LATE (See Instructions) 1. 2. 3. 4. 5. 8. 9. 10. 11. 12. 6. 7. 9. CREDITS (Overpayments as determined by the Department) V2025.1

# MEDICAL MARIJUANA TAX RETURN

Definitions: For the purposes of this document, the "Department" shall refer to the Nevada Department of Taxation. 1. The sellers cost for the medical marijuana sold 3. Any amount for which credit is given to the purchaser by the seller 4. Any charges by the seller for any services necessary to complete the sale a. Medical Marijuana Dispensaries b. Facilities for the production of edible marijuana products or marijuana-infused products or; c. Other Cultivation Facilities 2. Acquires, possesses, cultivates, delivers, transfers, transports, supplies or sells marijuana and related supplies to: 1.Is registered with the Division of Public and Behavioral Health of the Department of Health and Human Services pursuant to NRS 453A.322; and, The following de finitions are to be used to determine the classification of the facility relating to the payment of the Medical Marijuana Tax. Sales Price: The term "sales price" means the total amount for which medical marijuana is sold, valued in money, whether received in money o r otherwise, without any deduction for: 2. The cost of materials used, labor or service cost, interest, losses, all costs of transportation to the seller, and any other expense incurred by the seller Cultivation Facility: A "Cultivation Facility", as defined in NRS 453A.056 means a business that: 5. Sales price does not include the amount of the seller's obligation for the excise tax on medical marijuana Production Facility (Facility for the production of edible marijuana products or marijuana infused products): as defined in NRS 453A.105: means a business that: 1. Is registered with the Nevada Division of Public and Behavioral Health of the Department of Health and Human Services pursuant to NRS 453.A.322 and 2. Acquires, possesses, manufactures, delivers, transfers, transports, supplies or sells edible marijuana products or marijuana-infused products to medical marijuana dispensaries Med ical Mari juana Dispensary: A "Medical Marijuana Dispensary", as defined in NRS 453A.115 means a business that: 1. Is registered with the Nevada Division of Public and Behavioral Health of the Department of Health and Human Services pursuant to NRS 453.322 and 2. Acquires, possesses, delivers, transfers, transports, supplies, sells or dispenses marijuana, edible marijuana, and marijuana-infused products, and related supplies and educational materials to the holder of a valid registry identification card. A "Cultivation Facility" may sell to another Cultivation facility, Production Facility or to a Medical Marijuana Dispensary. An excise tax is imposed on each wholesale sale in this State of marijuana made by the Cultivation Facility at the rate of 2 percent of the sales price. The excise tax imposed for those parti cular sales are the obligation of the Cultivation Facility. A "Medical Mariju ana Dispensary" may sell or dispense marijuana, edible marijuana products or marijuana-infused products to the holder of a valid registry identification card. An excise tax is imposed on the retail sales price at the rate of 2 percent of the sales price for those products. The excise tax imposed for those particular sales are the obligation of the Medical Marijuana Dispensary. A "Production Facility" may produce and sell edible marijuana or marijuana-infused products to a "Medical Marijuana Dispensary" only. An excise tax is imposed on each wholesale sale in this State of those products at the rate of 2 percent of the sales price. The excise tax imposed for those particular sales are the obligation of the Production Facility. Penalty & Interest. If this return is not submitted/postmarked and taxes are not paid on or before the due date as shown on the face of this return, the amount of penalty due is based on the number of days the payment is late per NAC 360.395 (see table below). The maximum penalty amount is 10%. Determine the number of days late the payment is, and multiply the net tax owed (Line 5) by the appropriate rate based on the table below. The result is the amount of penalty that should be entered. For example, the taxes were due January 31, but not paid until February 15. The number of days late is 15 so the penalty is 4%. To calculate interest for each month late, multiply Line 5 x 0.75% (or .0075). The penalty and interest amounts are automatically calculated if you complete this form on-line. Number of days late Penalty Percentage Multiply by: 1 - 10 2% 0.02 11 - 15 4% 0.04 16 - 20 6% 0.06 21- 30 8% 0.08 31 + 10% 0.10 V2025.1