Form L-150 - Transient Lodgings Tax Registration Form

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CITY OF
TRANSIENT LODGINGS
PORTLAND, OREGON
TAX
REGISTRATION FORM
BUREAU OF LICENSES
An Equal Opportunity Employer
Office Use Only
Account #
PLEASE PRINT OR TYPE
Total Number of Rooms ________
Hotel/Motel Name__________________________________________________________________________
Address __________________________________________________________________________________
_______________________________________ Business Phone # ____________________________
Taxpayer ID # ____________________________ Business License #_________________________________
Date of Acquisition/Purchase ________________ E-mail Address ____________________________________
Mailing Address ____________________________________________________________________________
____________________________________________________________________________
Name of Contact Person _____________________________________________________________________
Owner’s Name _____________________________________________________________________________
Tax Entity:
Sole Proprietor
Partnership
Corporation
Estate
Trust
Ltd. Liability Co.
Ltd. Partnership
S-Corporation
Other:
(check one)
List Owner, Partner, or Corporate Officers:
NAME
TITLE
RESIDENCE ADDRESS
PHONE NO.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
If more room is needed, please continue on the back of this form.
Please Note:
Section 6.04.110, Paragraph (a) of the Code to levy a Transient Lodgings Tax provided that a security deposit not
to exceed twice the operator’s estimated average quarterly liability may be required for the period in which the
tax returns are filed. This security deposit, if required, may be in the form of cash, bond, or other security
deemed proper by the Bureau.
Signature _______________________________________________ Date __________________________
L-150 Rev. 2/00

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