Form Ta-41 - Transient Accommodations Tax - Time Share Occupancy Periodic Return

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FORM TA-41
STATE OF HAWAII — DEPARTMENT OF TAXATION
DO NOT WRITE IN THIS AREA
40
(REV. 2008)
TRANSIENT ACCOMMODATIONS TAX —
TIME SHARE OCCUPANCY
PERIODIC RETURN
NAME:
9
MONTH OF
,
(Do not combine your filing for more than one month, if filing monthly.)
9
T.S.O. REG. NO. ____________
QUARTER OF
,
(Do not combine your filing for more than one quarter, if filing quarterly.)
9
SEMIANNUAL PERIOD OF
,
(Do not combine your filing for more than one semiannual period, if filing semiannually.)
COLUMN A
COLUMN B
COLUMN C
Total Fair Market Rental Value
Rate
Taxes
(Multiply column A by column B)
1
TAXATION DISTRICT 1
1
.0725
(OAHU)
2
TAXATION DISTRICT 2
2
.0725
(MAUI, MOLOKAI, LANAI)
3
TAXATION DISTRICT 3
3
.0725
(HAWAII)
4
TAXATION DISTRICT 4
4
.0725
(KAUAI)
TOTAL TAXES DUE (Add lines 1
IF YOU DO NOT HAVE ANY FAIR MARKET RENTAL VALUE, AND THE RESULT IS NO TAX
5
DUE, ENTER “0” ON LINE 5. THIS RETURN MUST BE FILED.
thru 4 of column C, and enter here)
5
6a
6a
FOR LATE FILING ONLY
PENALTY
6b
6b
INTEREST
PLEASE ENTER AMOUNT OF
Make check payable to “HAWAII STATE TAX COLLECTOR” in U.S.
7
7
YOUR PAYMENT
dollars drawn on any U.S. bank. Write your T.S.O. Registration
(add lines 5, 6a, and 6b )
Number on the check.
— MAILING ADDRESS —
I declare, under the penalties set forth in section 231-36, HRS, that this is a true and correct return, prepared
in accordance with the provisions of the Transient Accommodations Tax Law, chapter 237D, HRS.
HAWAII DEPARTMENT OF
TAXATION
IN THE CASE OF A CORPORATION OR PARTNERSHIP, THIS RETURN MUST BE SIGNED BY AN OFFICER, PARTNER OR MEMBER, OR DULY
AUTHORIZED AGENT.
P.O. Box 2430
Honolulu, HI 96804-2430
SIGNATURE
TITLE
DATE
(
)
DAYTIME PHONE NUMBER:
40
FORM TA-41
THIS SPACE FOR DATE RECEIVED STAMP

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