Form Hom - Hotel Tax Return - State Of Rhode Island Division Of Taxation
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1STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
HOTEL TAX RETURN
DIVISION OF TAXATION - ONE CAPITOL HILL - STE 4 - PROVIDENCE, RI 02908-5802
HOM
NAME
ADDRESS
1. TOTAL OCCUPANCY
CONSIDERATION
CITY, STATE & ZIP CODE
2. LESS: EXEMPT ENTITIES
SIGNATURE OF OWNER, PARTNER OR AUTHORIZED AGENT
3. TAXABLE AMOUNT
HOTEL TAX RATE: 5% STATE TAX
DATE
FORM HOM
TITLE
1% LOCAL TAX
REVD 04/2016
$
4. TAX AMOUNT DUE AND PAID
(LINE 3 MULTIPLIED BY 6%)
FEDERAL IDENTIFICATION NUMBER
RETURN FOR MONTH ENDING
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