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.
Address Line 1:
Address Line 2:
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.