Form 72-225-08-1-1-000 - Occupancy Tax Return

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DIRECT 412
Form 72-225-08-1-1-000 (Rev. 9/08)
Mississippi
722250811000
Occupancy Tax Return
SO
Instructions
See reverse for detailed instructions.
Round to nearest dollar. Do not include pennies.
Copies or reproductions of the official form are not acceptable.
This return must be filed, even if no tax is due.
Failure to submit your return on the original form may result in a
Due Date
Due 1st to 20th; delinquent after 20th. Add penalty
penalty.
if delinquent.
Filing Period
Name
Month
Year
m m
y y
Monthly
Address
OR
City
State
ZIP
QUARTERLY
First Month
Last Month
Year
OR
m m
m m
y y
to
ANNUAL
If your Account Number is not on the label or no
Account
label is present, enter your Account Number here.
Number
You MUST use the filing
Quarterly: 01 to 03, 04 to 06, 07 to 09, or 10 to 12
period assigned by the
Annual: 01 to 12
Tax Comm. Only Standard
-
-
Filing
Periods
May
be
Used.. The periods are:
Change of
ADDITIONAL Tax
FINAL Return
Address Change.
AMENDED Return.
Close Account
Status
Make changes above.
(Column 1)
(Column 2)
(Column 3)
Number of Occupied Room Days
Rate of Tax
Amount of Tax
,
,
.
...................$0.75 Per Day.........
00
,
,
.
...................$1.00 Per Day.........
00
,
,
.
...................$2.00 Per Day.........
00
,
.
00
1.
Tax Due...........................................................................
,
.
00
2.
Late Filing Penalty (See Instructions).................................
,
.
00
3. Credit Adjustments (See Instructions).................................
,
.
00
4.
Additional Assessments (See Instructions).........................
,
.
00
5.
Total Due.........................................................................
I declare, under the penalties of perjury, that this return (including any accompanying schedules) has been examined
by me and to the best of my knowledge and belief is a true, correct and complete return.
Signature of Taxpayer or Agent
Date
Phone Number
Mail Return To:
Mississippi Tax Commission
P. O. Box 960
Jackson, MS 39205

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