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Public Accommodations Tax Return Hotel/Motel Taxes

Instructions:
Complete form, click the submit button and enter in your payment on the next page.

Please note, online payments require an additional 2.9% to cover administrative costs. This cost will automatically be added to your balance due.

First Name:

Last Name:

Company Name:

Address Line 1:

Address Line 2:

City:

State:

Zip:

Daytime Telephone:

Email Address:

Gross Room Rent or Charges

Less Exempt Rent on Charges (over 95 days)

Net Taxable Rent or Charges

Amount of Tax Due Net x 5%

Less 3% of Tax Due if Submitted by the 15th

Net Amount of Tax Due

By submitting this return I hereby certify that the above is a true and accurate representation of rental payments received for the period stated.