Form Ht-Aa03 Hotel Tax Amnesty Application And Registration For Small Hotels printable pdf download

NYC

HOTEL TAX AMNESTY APPLICATION

AND REGISTRATION FOR SMALL HOTELS

HTX

F I N A N C E

NEW YORK

Name of Hotel Operator/Owner:

EMPLOYER IDENTIFICATION NUMBER

Address (no. & street):

City and State:

Zip:

SOCIAL SECURITY NUMBER

Name of Hotel:

Address (no. & street):

City and State:

Zip:

Type of Hotel (check one, see instructions):

apartment

bed & breakfast

other (attach explanation)

No. of rentable rooms (if 10 or more, you are not eligible for small hotel tax amnesty. See instructions):

Name & Telephone No. of Contact Person at Operator/Owner:

Business Entity Type of Hotel Operator/Owner (check one)

corporation

partnership or LLC

individual

If you checked "corporation" or "partnership," list below the name, address & EIN or SSN for each officer, general partner or managing member, respectively.

Attach a separate sheet if necessary.

1. Name: ________________________________________________________

No. & Street: ___________________________________________________

City: ______________________________________ State: _____________

Zip: _______________ EIN/SSN:

2. Name: ________________________________________________________

No. & Street: ___________________________________________________

City:_______________________________________ State: _____________

Zip: _______________ EIN/SSN:

I certify that I am eligible for amnesty and that the information on this application, accompanying

C E R T I F I C A T I O N

returns, and schedules is, to the best of my knowledge, true, correct, and complete.

Preparer's Telephone Number

I authorize the Dept. of Finance to discuss the processing of this return with the preparer listed below: (see instructions)....YES

IGN

Signature

Title

Date

HERE

Preparer's Social Security Number or PTIN

Check if self-

Preparer's signature

employed

Date

REPARER

USE

Firm's Employer Identification Number

ONLY

Firm's name

(or yours, if self-employed)

Address

Zip Code

If you are applying for amnesty with respect to a pending

If your amnesty application DOES NOT involve a pending

administrative or court proceeding, mail this application with the

administrative or court proceeding, mail this application with

required returns and payments to:

the required returns, payments, and attachments to:

New York City Department of Finance

Tax Amnesty

Office of Legal Affairs

P.O. Box 5170

345 Adams Street, 3rd Floor

Kingston, NY 12402-5170

Brooklyn, NY 11201

ATTENTION: HTX AMNESTY

Tax returns should be mailed with your application, NOT to the

address shown on the return forms.

HT-AA03 rev. 10/22

00410391

Form Ht-Aa03 Hotel Tax Amnesty Application And Registration For Small Hotels

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