Form Rd-106 - Convention & Tourism Tax - Hotel/motel - City Of Kansas Revenue Division, Missouri

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CONVENTION & TOURISM TAX - HOTEL/MOTEL
RD-106
City of Kansas City, Missouri
Phone
(816) 513-1120
(09/09)
Revenue Division
Free E-filing:
Period From:
Period To:
Legal Name:
FID Number:
Mailing Address:
Account ID:
DBA Name:
Business Address:
Due Date:
For changes to name, address or FEIN/SSN, please contact us at or (816) 513-1135.
M
M
D
D
Y
Y
/
/
1. Date if closed
2. X box if amended
DOLLARS
CENTS
3. Gross Receipts
4a.Total Increase from Worksheet RD106W +
-
4b.Total Decrease from Worksheet RD106W
5. Taxable Sales
6. Total Tax Due (Rate: 7.50% of Taxable Sales)
7. 2% Timely (only if paid before due date)
-
8. Tax Due
9. Interest (3% per annum until tax is paid in full) +
10. Penalty (5% per month, not to exceed 25%) +
11. Previous Credit -
12. Amount Due
13. Amount Paid
Make check payable to: CITY TREASURER
DO NOT SEND CASH
M ail return to P.O. Box 802106, KCMO 64180-2106
Under penalties of perjury, I declare this to be a true, correct, and complete return f or the tax period stated.
Yes
No
I authorize the Com missioner of Revenue or delegate to discuss my return and attachm ents with my preparer.
Taxpayer Signature
Print Name
Title
Date
Phone
Preparer's Signature (if other than taxpayer)
Print Name
Title
Date
Phone
Draft

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