Transient Occupancy Tax Type "A" Exemption Certificate For Governmental Agencies printable pdf download

ITY AND

OUNTY OF

RANCISCO

& T

- B

FFICE OF THE

REASURER

OLLECTOR

USINESS

ECTION

Street Address: 1 Dr. Carlton B. Goodlett Place, Room 140, San Francisco, CA 94102

Mailing Address: P.O. Box 7425, San Francisco, CA 94120-7425

José Cisneros

Treasurer

TRANSIENT OCCUPANCY TAX

TYPE “A” EXEMPTION CERTIFICATE FOR GOVERNMENTAL AGENCIES

This form is to be completed by a representative or employee of a governmental agency requesting an exemption from San Francisco’s

Transient Occupancy Tax under Sec. 6.8-1 (1), (2) or (3) of the San Francisco Business and Tax Regulations Code. The operator, as defined

under Article 7 Sec. 501 of the Business and Tax Regulations Code, must retain this completed form and supporting documents for five years.

Name of Operator:

Address:

San Francisco, CA

(Number & Street)

( Zip)

Dates of Occupancy:

Amount

(Check In:)

(Check Out:)

Paid for the Room: $

Employee Name:

(First Name)

(Last Name)

Employee Address:

Employee Telephone #:

Driver’s License:

(

)

(State)

(Number)

Type of Government:

Federal

State of: ______________

Local Government:______________

Governmental Agency:

(Name of Agency)

Home Office Location:

(Address)

(City)

(State)

(Zip)

(

)

Agency Telephone #

I hereby declare under penalty of perjury that I am a representative or employee of the governmental agency

indicated above; and that such charges are incurred in the performance of my official duties as a representative or

employee of such agency; and that the foregoing facts and statements are true and correct.

Executed at:

(City)

(State)

Signature:

Date:

NOTE:

In all cases in which the tax is not collected by the operator, the operator shall be liable to the Tax Collector of the

City and County of San Francisco for the tax due on the taxable rent received for the rental as though the tax had

been paid by the occupant.

Operators should not accept this certificate unless the person presenting it submits satisfactory proof that he/she

meet the requirements for the exemption ( e.g. Government Agency Calling Card, Agency Letter, or Identification

Card). A separate exemption certificate is required for each occupant claiming this exemption.

TO BE COMPLETED BY OPERATOR/STAFF

This exemption is not valid unless the occupant's Government Agency Calling Card,

Agency Letter, or ID Card is attached.

Verified by:

___________________________________

_____________________________

_______________________

Print Employee’s Name

Employee’s Signature

Date

San Francisco Municipal Code, Part III, Article 6, §6.8-1. CITY, PUBLIC ENTITY AND CONSTITUTIONAL EXEMPTIONS:

Nothing in Articles 6, 7, 10, 10A, 11, 12 or 12-A shall be construed as imposing a tax upon:

(1) The City;

(2) The State of California, or any county, municipal corporation, district or other political sub-division of the State, except where any constitutional or statutory immunity

from taxation is waived or is not applicable;

(3) The United States of America, or any of its agencies or subdivisions, except where any constitutional or statutory immunity from taxation is waived or is not applicable.

TOT Type A Exemption Form

(Previous editions of this form are not valid)

Rev Mar 2014