Transient Occupancy Tax (Tot) Return - City Of Mesa Page 2
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1
2Revenue Collections Operations
Licensing Office
Location:
License: ___________________________
Mailing:
55 North Center Street
PO Box 16350
Reporting Period: ___________________
Mesa, Arizona 85201
Mesa, AZ 85211-6350
Due Date: _________________________
Phone: (480) 644-2316
Fax:
(480) 644-3999
Hours: 7:00 AM – 6:00 PM
MONTH ___________________________
Business Name / Mailing address:
CANCEL LICENSE:
Check here and sign at the
bottom to cancel your license.
Reason _____________________
Date Business Closed __________
TRANSIENT OCCUPANCY TAX (TOT) RETURN
If you have any questions regarding this Tax Return, Please call the City of Mesa at (480) 644-2316.
PLEASE USE BLACK INK!
Part 1 – Gross Income
Total amount charged for transient occupancy of space including the use of
furnishings.* (Do NOT include Tax collected in this amount.)
Part 2 – Calculation of Tax
(1)
3% of Gross Income
(2)
Excess Tax Collected
(3)
Penalty and Interest **
Total Due
Add (1), (2) and (3)
Part 3 - Affirmation
I swear (or affirm) that this return has been examined by me and that due to the best of my knowledge and belief, it is a true
and complete return for this period.
Taxpayer’s Signature
Date
Paid Preparer’s Signature
Print Taxpayer’s Name
Phone (Required)
Print Paid Preparer’s Name
th
The due date for the Transient Occupancy Tax (TOT) is the 20
of the month following the reporting period. A return is
considered timely if received by the last business day of the month. A business day is any day except Friday, Saturday, Sunday,
or legal City holiday.
* Transient Occupancy – The tax due on occupancy for the first 29 consecutive days.
** Penalty – Failure to file is 5% of tax due, accumulating monthly. Failure to pay is 10% of tax due. Combined penalties not to exceed 25%
Interest - Interest rate is the same as the State rate and continues to accrue until taxes are paid.
A SIGNATURE IS REQUIRED TO MAKE THIS RETURN VALID
Return original with remittance envelope provided.
Please make check payable to: CITY OF MESA
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