Lodging Tax Quarterly Return Form - State Of Oregon - 2006

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STATE OF OREGON LODGING TAX
FOR OFFICE USE ONLY
Date Received
Quarterly Return
•
Payment Received
Tax Year 2006
•
Quarter
Due Date
Business Identifi cation Number (BIN) Program Code Year
Period
Liability
1
•
•
•
•
525
06
1
01/01/06 to 03/31/06
April 30, 2006
525
06
03
1
Federal Employer Identifi cation Number (FEIN)
1st Quarter
Amended return? Yes c
Mailing Address:
Mailing address change? Yes c
Physical Site Ad dress:
See instructions on separate page.
c
c
A. Have you sold or closed your business and this is your last return?
Yes
No
c
c
B. Has ownership changed since the last reporting period?
Yes
No
Date business was bought/sold or closed: __________________ Current ownerʼs name: ________________________________
C. Number of taxable vacation rental properties .........
Note: If you are reporting taxable lodging sales from multiple vacation rental properties under this BIN, you MUST provide us with
a current list of each of your rental properties, including the physical address of each property. Attach the list to this return.
D. Number of taxable rooms or sites...........................
•
1. Total gross receipts for lodging sales ................................................................................................... 1
2. Non-taxable lodging sales.
See instructions.
STOP!
2a. Long-term or monthly rentals............................................................. 2a
2b. Federal employees on business ........................................................ 2b
2c. Other (describe) ______________________________________ .... 2c
•
2d. Non-taxable lodging sales TOTAL (add lines 2a, 2b, and 2c) ........................................................ 2d
0.00
3. Total taxable lodging sales (subtract line 2d from line 1) .................................................................... 3
0.00
4. Tax rate ................................................................................................................................................... 4
× 0.01
5. Tax due [multiply line 3 by line 4 (1%)] .................................................................................................. 5
0.00
6. Administrative fee rate ............................................................................................................................ 6
× 0.05
7. Administrative fee [multiply line 5 by line 6 (5%)] ................................................................................... 7
0.00
•
$
8. TOTAL TAX DUE (subtract line 7 from line 5) ........................................................................................ 8
0.00
DECLARATION: I declare under the penalties for false swearing [ORS 305.990(4)] that I have examined this document and to the best
of my knowledge it is true, correct, and complete.
Signature
Date
X
PRINT Name Signed Above
Title
Telephone Number
(
)
150-604-002-1 (Rev. 3-06)
Mail this return on or before the due date shown above to: STATE OF OREGON LODGING TAX
OREGON DEPARTMENT OF REVENUE
PO BOX 14110
SALEM OR 97309-0910

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