Hotel/motel Occupation Tax Monthly Remittance Return - City Of Omaha

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CITY OF OMAHA HOTEL/MOTEL OCCUPATION TAX
MONTHLY REMITTANCE RETURN
Nebraska I.D. Number ____________________
For the month of __________________, 20_____
LOCAL LOCATION
MAILING ADDRESS
Hotel/Motel Name: __________________________
Name:
_________________________
Street Address:
__________________________
Address:
_________________________
Omaha, Nebraska Zip: ___________
City: __________
State: ________ Zip _________
Telephone # : ______________
Telephone # : ______________
Local Manager: ________________________
Contact Name: _____________________
(1) Total revenue received for rooms during month
(2) Less: Room revenue not subject to tax
(3) Adjustment for prior month (explain below)
$0.00
(4) Net taxable revenue for the current month
(5) Occupation tax due ( Line 4 x 5.5%)
(6) Less Collection Fee (Line 5 x 2%)
(7) Total amount owed the City of Omaha
Explanations:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Sign Here: __________________________________
_______________________________________
Authorized Signature
Printed Name
Telephone ____________________________
Date
______________________
Instructions:
Please send two copies of this form and the amount due on (7) to:
CITY CENTRAL CASHIER, RM. H10
OMAHA/DOUGLAS CIVIC CENTER
OMAHA, NE 68183
PRINT

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