Page 22 - Business Toolkit

CITY OF HANFORD

Finance Department
315 N. Douty Street
Hanford, California 93230

TRANSIENT OCCUPANCY TAX QUARTERLY RETURN

For Period Ending

Name of Hotel/Motel

Number of Rooms Available
Typical/Daily Rental Rate $

1) Total Rent for Occupancy of Rooms $

Allowable Deductions

2) Permanent Residents $

3) Government Agencies $

4) Adjustment (explain on reverse side) $

5) Total Deductions $

6) Taxable Rents, line 1 minus line 5 $

7) 8% Tax Collected for Transient Occupancy $

8) Penalty $

9) Interest $

10) Total Amount Due and Payable $

DATED at
I certify (or declare) under penalty of perjury, the foregoing statements are true and correct.

Signed
At
Title

Date Signed
Penalty and interest will be added if payment
is delinquent. MAKE CHECK PAYABLE TO THE CITY OF HANFORD

Original: City of Hanford