July - August - September 2007 Lodging Addendum Form Page 6
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8January - February - March 2007
07
Q1
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]
Location Code
Number of Unit/Days
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
=
Location Code
Number of Unit/Days
Unit/Day Rate Charged
Total Charges Due
.
,
.
7.
X
=
Location Code
Number of Unit/Days
Unit/Day Rate Charged
Total Charges Due
.
,
.
8.
X
=
9.
Total Tourism Promotion Area Lodging
,
.
Reminder:
Attach this addendum to
Charges
(Add charges due, lines 1 - 8)
your original return and
Add all Addendum totals and transfer
mail to the Department.
the amount to the Total All Addendums
line on your tax return.
For tax assistance, visit To inquire about the availability 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
(10-30-06)
Page
2
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