September 2007 Lodging Addendum Form Page 4

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August 2007
08 07
Lodging Addendum
Use Black Ink and Attach this Original Addendum to Your Retailing & Other Activities Return.
Name:
Tax Registration Number
Lodging Charges
Note: See the Lodging Charge Special Notice for your county’s rates on our web site at
Tourism Promotion Area Lodging Charge [170]
Number of Unit/Days
Location Code
Unit/Day Rate Charged
Total Charges Due
,
.
.
1.
x
=
Location Code
Number of Unit/Days
Unit/Day Rate Charged
Total Charges Due
,
.
.
2.
x
=
Location Code
Number of Unit/Days
Unit/Day Rate Charged
Total Charges Due
,
.
.
3.
x
=
Location Code
Number of Unit/Days
Unit/Day Rate Charged
Total Charges Due
,
.
.
4.
x
=
Location Code
Number of Unit/Days
Unit/Day Rate Charged
Total Charges Due
,
.
.
5.
x
=
Location Code
Number of Unit/Days
Unit/Day Rate Charged
Total Charges Due
,
.
.
6.
x
=
Number of Unit/Days
Location Code
Unit/Day Rate Charged
Total Charges Due
,
.
.
7.
x
=
Number of Unit/Days
Location Code
Unit/Day Rate Charged
Total Charges Due
,
.
.
8.
x
=
9. Total Tourism Promotion Area
,
.
Reminder: Attach this addendum to
Lodging Charges
(Add charges due,
Add all Addendum totals and transfer
your original return and
lines 1-8)
the amount to the Total All Addendums
mail to the Department.
line on your tax return.
For tax assistance, visit or call 1-800-647-7706. To inquire about the availablitily of this document in an alternate format for
the visually impaired, please call (360) 705-6715. Teletype (TTY) users may call 1-800-451-7985.
Internet/Fax
(7-11-07)
Page 2

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