Fillable Form Ta-1 - Transient Accommodations Tax Return

Form Ta-1 - Transient Accommodations Tax Return - 2005

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DO NOT WRITE IN THIS AREA

STATE OF HAWAII — DEPARTMENT OF TAXATION

FORM TA-1

(REV. 2005)

TRANSIENT ACCOMMODATIONS TAX RETURN

NAME:__________________________________________

o Month o Quarter o Semiannual Period

Beginning __________ , 20____ and Ending ___________ , 20____

(Do not combine your income for more than one filing period on this return.)

__ __ __ __

HAWAII TAX I.D. NO. W __ __ __ __ __ __ __ __ - __ __

Last 4 Digits of Your FEIN or SSN:

GROSS RENTAL OR

EXEMPTIONS/DEDUCTIONS

TAXABLE PROCEEDS

RATE

TAXES

GROSS RENTAL PROCEEDS

(EXPLAIN ON REVERSE SIDE)

DISTRICT

TAXATION DISTRICT 1

.0725

(OAHU)

TAXATION DISTRICT 2

.0725

(MAUI, MOLOKAI, LANAI)

TAXATION DISTRICT 3

.0725

(HAWAII)

TAXATION DISTRICT 4

.0725

(KAUAI)

IF YOU DO NOT HAVE ANY GROSS RENTAL OR GROSS RENTAL

TOTAL TAXES DUE

PROCEEDS, AND THE RESULT IS NO TAX DUE, ENTER “0” IN EACH

(ADD LINES 1 thru 4 of column d,

COLUMN FOR THE APPLICABLE TAX DISTRICT(S) AND ON LINES 5 AND 8.

AND ENTER HERE)

PENALTY

FOR LATE FILING ONLY

INTEREST

ATTACH YOUR CHECK OR MONEY ORDER PAYABLE TO “HAWAII STATE TAX COLLECTOR”

TOTAL PAYMENT

IN U.S. DOLLARS DRAWN ON ANY U.S. BANK AND FORM VP-1T TO FORM TA-1. WRITE “TA”,

(ADD LINES 5, 6a, and 6b;

THE FILING PERIOD, AND YOUR HAWAII TAX I.D. NO. ON YOUR CHECK OR MONEY ORDER.

ENTER AMOUNT HERE)

GRAND TOTAL EXEMPTIONS/DEDUCTIONS FROM BACK OF FORM

I declare, under the penalties set forth in section 231-36, HRS, that this is a true and correct return, prepared in

accordance with the provisions of the Transient Accommodations Tax Law, Chapter 237D, HRS and the rules issued

thereunder.

A CORPORATION OR PARTNERSHIP TAX RETURN MUST BE SIGNED BY AN OFFICER, PARTNER OR MEMBER, OR DULY AUTHORIZED AGENT OF SUCH ENTITY.

SIGNATURE

TITLE

DATE

NOTE:

This form may be electronically filed (e-filed) with the Department of Taxation.

For more information, go to

— MAILING ADDRESS —

HAWAII DEPARTMENT OF TAXATION

FORM TA-1

P.O. BOX 2430

HONOLULU, HI 96804-2430

" -

DETACH HERE-

DO NOT WRITE OR STAPLE IN THIS SPACE

STATE OF HAWAII — DEPARTMENT OF TAXATION

Form

TAX PAYMENT VOUCHER

VP-1T

TRANSIENT ACCOMMODATIONS

(Rev. 2005)

Period Beginning

and Ending

DO NOT SUBMIT PHOTOCOPIES OF THIS FORM

MM/DD/YY

Hawaii Tax I.D. No.

LAST 4 DIGITS OF YOUR FEIN OR SSN

Print the amount of your payment in the space provided. ATTACH THIS

VOUCHER WITH CHECK OR MONEY ORDER PAYABLE TO “HAWAII

STATE TAX COLLECTOR” TO FORM TA-1. Write “TA”, the filing

period, and your Hawaii Tax I.D. No. on your check or money order.

Name

Amount of Payment

2004400090115

Form Ta-1 - Transient Accommodations Tax Return - 2005

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