TGR
KANSAS DEPARTMENT OF REVENUE
TRANSIENT GUEST TAX RETURN
(VAL)
(REEL)
(BLIP)
DO NOT WRITE ABOVE THIS LINE
Taxpayer I.D. No. (TPID)
Filing Period (FPDT)
Local Code (LOC)
THIS RETURN MUST BE FILED AND THE TAX PAID BY
1. Total gross receipts from charges for sleeping accommodations . . . . . . . . . . . . . . . . . . . . . . . . (GTX)
1
2. Allowable deductions (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(RO28)
2
3. Amount subject to tax (Line 1 less line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(NTBS)
3
4. Amount of tax due (Multiply lines 3 times
%) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (TAX)
4
5. Amount of penalty (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
6. Amount of interest (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
7. Total amount due (Add lines 4, 5 and 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8. Credit from prior period(s) (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(PRCR)
8
9. Amount remitted (Line 7 minus line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
FOR OFFICE USE ONLY
Doc Exam Codes (EXC)
(EXDT)
Sub Trans Code (STRC)
I certify that this is a true, correct and complete return.
(
)
Signature
Business Phone Number
Mail this return and remittance to: Miscellaneous Tax, Kansas Department of Revenue, 915 SW Harrison Street, Topeka, Kansas
66612-1588. Make remittance payable to Transient Guest Tax. Be sure to write your Transient Guest Tax account number and filing
period on your check or money order.
FOR OFFICE USE ONLY
TG-1 (Rev. 7/13)
Doc Received Date __________________________