Quarterly Report Form - Collections Of Short Term Rental Tax - Sample
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1
2Quarterly Report
Collections of Short Term Rental Tax
Instructions:
This form and payment must be submitted on or before the 20th of the month following the
quarter being reported.
Short Term Rental Tax Business ID. No.
March
For the Quarter Ending
Business Name (if applicable)
Last Name (if applicable)
First Name
Mailing Address
City
State
Zip
Trade Name
Physical Address
City
State
Zip
1. Gross Receipts from All Rentals
2. Gross Receipts from Short Term Rentals
3. Less Allowable Deductions (Attach List)
4. Balance (Taxable) (Line 2 Less 3)
5. 1% Tax on Line 4
6. Penalty for Late Payment (10% of Line 5) ($10.00 min)
7. Interest @ 10% per annum on Line 5 & 6
8. Total Tax, Penalty and Interest (Sum of 5, 6, & 7)
Method of Payment:
On-line (E-check)
(To pay on-line click here.)
By mail (Make checks payable to: Treasurer, County of York)
*
*Please Note: If submitting payment by mail, you must enclose a copy of this form as well as fill in the
boxes below for the amount of payment enclosed and check #.
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