Monthly Return Of Hotel-Motel Room Tax Form - City Of Richmond
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1City of Richmond
Monthly Return of Hotel-Motel Room Tax
Name:______________________________
Month Ending:_____________________
Mailing Address:
Location (if other than mailing address):_______________________________________
Occupational License Fee Account Number: ____________________
INSTRUCTIONS FOR PREPARATION OF RETURN
1.
File return even though no tax is due.
th
2.
File return on or before the 20
of month following the month in which
the tax is collected.
3.
Report immediately by letter any changes of ownership or address.
4.
Prepare this return in duplicate and retain one copy for your files.
COMPUTATION OF TAX
1. Total rooms available:
___________________________
2. Percent of occupancy:
___________________________
3. Estimated average room rate:
___________________________
4. Gross room rentals:
___________________________
5. Less permanent guest rentals:
___________________________
6. Taxable Rentals (Line 4 minus Line5):
___________________________
7. Tax (3% of Line 6):
___________________________
8. Penalty (10% of Line 6 if paid late):
___________________________
9. Interest (1% of Line 6 per month until paid):
___________________________
10. Total payment due (Total of Lines 7, 8, and 9): ___________________________
I hereby certify that the statements made herein and in any supporting schedules are true,
correct and complete to the best of my knowledge.
RETURN MUST BE SIGNED: ____________________________________________
Signature of Preparer
Date
MAKE CHECKS PAYABLE TO:
City of Richmond
P.O. Box 1268
Richmond, KY 40476-1268
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