Lodging Tax Form - City Of Fayette, Alabama
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1LODGING TAX FORM
City of Fayette
nd
102 2
Avenue S.E.
Fayette, Alabama 35555
(205)932-5367, Fax (205)932-8788
____________________________
Reporting Month ___________
From
____________________________
____________________________
1. (a) Total gross charges, both cash and credit, from rental of rooms,
lodging, accommodations and services furnished for the period
covered by this report
$__________
(b) Total collections made during the month on credit charges
claimed as a deduction
$__________
2.
Total gross charges from the renal of rooms, lodgings,
accommodations, services, and collections claimed as a deduction
$__________
3.
TOTAL AMOUNT REMAINING AS MEASURE OF TAX
$__________
4.
Amount of Tax (equals 4% of line 3)
$__________
th
Penalty ($25 if received after 20
)
$__________
Total Amount Due
$__________
_______________________________________
______________________
Signature of Authorized Agent
Date
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