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Transient Lodgings Tax Government Exemption Certificate Form - City Of Portland,oregon

CITY OF

111 SW ColumbiaSt., Ste 600

PORTLAND, OREGON

Portland, OR 97201

(503) 823-5157

Fax: (503) 823-5192

BUREAU OF LICENSES

TDD: (503) 823-6868

An Equal Opportunity Employer

TRANSIENT LODGINGS TAX

GOVERNMENT EXEMPTION CERTIFICATE

City of Portland Code Section 6.04.050 states no tax shall be imposed upon:

Any Federal Government employee travelling on official government business, who presents an

official Government Exemption Certificate or official travel authorization.

Name of Hotel/Motel:___________________________________________________________

Address of Hotel/Motel:_________________________________________________________

Occupancy From: (check-in date)____________ To: (last date of occupancy) ___________

Sum (in $) of Rents Paid: ___________________

This is to certify that I, the undersigned, am an employee of the United States

Government Agency indicated below; that the charges for the occupancy at the above

establishment on the dates indicated above have been, or will be, paid for by such

Governmental Agency; and that such charges are incurred in the performance of my

official duties as an employee of such Governmental Agency.

_________________________________

___________________________________ _______20__

(Federal Governmental Agency)

(Signature of Federal Employee)

(Date)

IMPORTANT:

Operators of Hotels/Motels must not accept this certificate unless the person presenting it shows satisfactory

credentials. Therefore, a photocopy of a federal ID card or a business card with logos of the Federal

Government Agency must be attached or stapled to this exemption request.

A separate exemption certificate is required for each occupancy and for each federal employee. If you have

any questions regarding allowable exemptions, please call the Bureau of Licenses Audit Section at (503) 823-

5286.

RETAIN THIS RECORD FOR A PERIOD OF NOT LESS THAN 3 YEARS AND 6 MONTHS

Transient Lodgings Tax Program

Transient Lodgings Tax Government Exemption Certificate Form - City Of Portland,oregon