Transient Occupancy Tax Registration Form - Kern County Treasurer-Tax Collector

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Office of the Treasurer/Tax Collector
Pursuant to Chapter 4.16 of Title 4 of the Kern County Code
TRANSIENT OCCUPANCY TAX REGISTRATION FORM
The following information requested must be completed in its entirety. Failure to do so is a violation of Section 4.16.060 of the chapter
and will be subject to penalties as outlined in Section 4.16.200.
COMPLETION OF THIS FORM IS REQUIRED FOR EACH LODGING BUSINESS OR VACATION RENTAL PROPERTY
“If the business is operated by a business entity, the names and addresses of the officers of the entity and the names and addresses of all partners or
shareholders holding more than a twenty percent (20%) equity interest in the entity shall be listed in the form. This registration form shall be signed by
the owner, if the owner is a natural person, by a member or partner, in the case of an association or partnership, and by an executive officer or some
person specifically authorized to act on behalf of a corporation.”
PLEASE PRINT OR TYPE
Type of Business (House, Hotel, Cabin, Vacation, etc.): ____________________
Number of Bedrooms/Units __________________
Business/Identifying Name: ___________________________________ Federal Tax ID #: ___________________________________
Business Phone: _________________________________Website:_____________________________________________________
Site Address: ________________________________________________________________________________________________
(Address, City, State, Zip)
Mailing Address (if different than site): ____________________________________________________________________________
(Address, City, State, Zip)
When did you begin to operate the business? (MM/DD/YYYY) _________________________________________________________
Amount Charged Per Day (do not leave blank) $______________
Do seasonal rates apply? (Please select)
YES
NO
If yes, please indicate amount:
Spring $_________
Summer $_________
Fall $_________
Winter $___________
Amount Charged Weekends/Holidays if different from above:___________________________________________________________
OWNER(S):
LEGAL Owner’s Name: ________________________________________________________________________________________
LEGAL Owner’s Address: ______________________________________________________________________________________
LEGAL Owner’s Phone: (Home) ___________________ (Work) ___________________ (Cell) ______________________________
Email Address_______________________________________________________________________________________________
OPERATOR (if different than owner(s) :
Operator’s Name: ____________________________________________________________________________________________
Operator’s Address: __________________________________________________________________________________________
Operator’s Phone: (Home) ____________________ (Work)_______________________ (Cell)______________________________
Email Address ______________________________________________________________________________________________
I declare, under penalty of perjury, that the above information is correct and that any changes made from the information
submitted above shall be reported to the Tax Collector within thirty (30) days of that change.
________________________________________
TAX COLLECTOR USE ONLY
Signature/Title
Certificate Number: _____________________
________________________________________
New Registration
Account Update
Date Signed
Assessor Tax Number: ____________________
Return to the Kern County Treasurer/Tax Collector. 1115 Truxtun Avenue, 2
Floor Bakersfield, CA 93301 or
kerntot@co.kern.ca.us
nd
KCTOT 060 (07/2015)

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