Form Cr 067 - Short Term Rental Tax - Spotsylvania County
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1Short Term Rental Tax
Account # ____________
Spotsylvania County, Virginia
Deborah F Williams, Commissioner of Revenue
PO Box 175, 9104 Courthouse Rd, Spotsylvania VA 22553-0175
Phone: 540.507-7051
Fax: 540.582-7421
Website:
Email:
cor@spotsylvania.va.us
INSTRUCTIONS
Complete Sections A, B & C.
th
File on or before the 20
day of the month following the close of each quarter.
th
In person – Deliver to our office by 4:30 on the 20
of the month.
th
– Postmark on or before the 20
of the month.
By mail
Make check payable to: Treasurer, Spotsylvania County
Mail to: Attn: Short Term Rental Division, Commissioner of Revenue, PO Box 175, Spotsylvania VA 22553-0175
If account number is omitted above, it could delay processing and may cause penalties.
A. Owner & Business Information
Owner’s Name
Phone
Mailing Address:
Block / Street Name
City
State
Zip
Trade Name
Phone
Physical Address:
Block / Street Name (No PO Boxes)
City
State
Zip
Social Security #
Federal ID
Email Address
B. Calculating Tax
1.
Total Gross Receipts for the Period of
$
Select Period
Select Year
Less Allowable Deductions
2.
<$
>
(If rental exceeds 93 consecutive days or more, it is exempt from tax.) (If Zero, enter “0.”)
3.
Taxable Rental Proceeds (Subtract Line 2 from Line 1)
$
4.
Calculate Tax - 1% Tax of Taxable Proceeds from Line 3 (Multiply Line 3 by 1%)
$
Penalty/Interest Information
Late Payment Penalty (If late, Multiply Line 4 by 10%)
5.
$
Interest (Accrues at rate of 10% per year)
*Interest will begin to accrue after the last day of the month following the due date.
6.
$
Total Due (Tax plus Penalty and Interest if applicable) (Add Line 4 and Line 5)
C. Declaration Of Seller
I declare that the foregoing statement and figures are true, complete, and correct to best of my knowledge.
__________________________________
__________________
Signature of Owner or Agent
Date
__________________________________________
______________________
Printed Name/Title
Phone
CR #067
For Office Use Only
Reporting Quarter
Due Date
Date ____/____/____
by ________
Check #_____________
st
th
1
Qtr
January
to
March
April 20
(online form
rev 12/1 /1 )
2
nd
Qtr
April
to
June
July 20
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3
rd
Qtr
July
to
September
October 20
th
Print Form
Clear All Fields
Clear Fields for Next Business Account
4
th
Qtr
October
to
December
January 20
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