Wood County Hotel/motel Occupancy Tax Reporting Form
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2WOOD COUNTY TAX ASSESSOR / COLLECTOR
P.O. Box 1919, Quitman, TX 75783 | 903-763-2261
Wood County Hotel/Motel Occupancy Tax Reporting Form
* A REPORT MUST BE FILED EVEN IF NO TAX IS DUE *
* A COPY OF YOUR STATE HOTEL OCCUPANCY TAX REPORT MUST BE SUBMITTED WITH THIS REPORT
1. Tax Payer Identification Number
2. Reporting Period (Month Ending)
3. Due Date
*Note: Due on or before the 20th day of the month
4. Taxpayer Name and Mailing Address
following the reporting month in Item 2.
Taxpayer Daytime Phone
5. Location
6. LODGING FACILITY NAME & PHYSICAL LOCATION ADDRESS
Capacity
(This includes Hotel, Motel, Marina, Lodging, Cabins, Bed & Breakfast)
Name
Street
Lodging Location Phone
City, State, Zip
Name
Mailing Address
NOTE: If location shown is no longer in business,
Of LOCATION
write "OOB" and the date you went out of business
Street
If Different than
beside that location. Reports are still due if location is
Physical location
City, State, Zip
operational but no receipts for the reporting period.
7. Total Room Receipts ...............................................................
7. _________________
8. - Total Tax Exemptions ............................................................
8. _________________
9. = Total Taxable Receipts .........................................................
9. _________________
10. Total Tax Due
......... 10. _________________
(7% of Taxable Receipts; Multiply Line Item #9 x .07)
11. - Discount
.... 11. _________________
(If paid on time*, deduct 1% of Tax Due; Multiply Line #10 x .01)
12. = Tax Due After Discount .
......................... 12. _________________
(Line 10 minus Line 11)
13. +/- Adjustment(s)
..__________________________.. 13. _________________
(if applicable).
14. + Penalty
................................. 14. _________________
(if late, according to State code, see instructions).
15. + Interest
................................. 15. _________________
(if late, according to State code, see instructions).
R
16. = TOTAL AMOUNT DUE
.......16. _________________
(Add lines 12 through 15 as applicable)..
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** REMEMBER TO ATTACH A COPY OF YOUR STATE HOTEL OCCUPANCY TAX REPORT TO THIS REPORT **
I declare that the information in this document and any attachments is true and correct
Make the Amount in Item 16 Payable to:
to the best of my knowledge and belief.
Carol Taylor
Wood County Tax Assessor/Collector
Signature
Date
P.O. Box 1919, Quitman, TX 75783
Printed Name
Preparer’s Daytime Phone:
903-763-2261
For assistance call
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