Transient Occupancy Tax Registration Form - James City County - 2013

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Transient Occupancy Tax Registration
COMMISSIONER OF THE REVENUE
JAMES CITY COUNTY, VIRGINIA
(757) 253-6698
IMPORTANT: TRANSIENT OCCUPANCY TAX IN JAMES CITY COUNTY IS 5%.
ADDITIONAL TRANSIENT OCCUPANCY TAX IS $2/ROOM NIGHT
Legal Business Name:
SSN:
-
-
FEIN:
-
Trade Name: _______________________________________________________________________________
Classifications
Hotel/Motel 
Campground
Other: _____________________________________________
Location Address ____________________________________________________________________________________
Mailing Address: ____________________________________________________________________________________
Business Phone: _________________________________________
FAX: ____________________________________
Date that business activity began or will begin at above location: ________________________________________________________
Person(s) responsible for filing monthly meals tax returns:
NAME AND TITLE
PHONE
______________________________________________________________
______________________________________
______________________________________________________________
______________________________________
IMPORTANT: NOTIFY THIS OFFICE IN WRITING OF ANY DELAY IN OPENING DATE, OR CHANGE OF RESPONSIBLE PERSONS.
I DECLARE THAT THE STATEMENTS AND FIGURES HEREON ARE TRUE, COMPLETE, AND ACCURATE TO THE BEST
OF MY KNOWLEDGE AND BELIEF, AND THAT I AM AUTHORIZED TO FILE THIS DOCUMENT ON BEHALF OF THE
ABOVE-NAMED BUSINESS.
SIGNATURE: ___________________________________________________
TITLE: _______________________________
PRINT NAME: __________________________________________________
DATE: _______________________________
Any person violating or failing to comply with any provisions of Tax on Prepared Food and Beverages Ordinance shall, upon conviction
thereof, be guilty of a Class 3 Misdemeanor. Such convictions shall not relieve any person from payment, collection, or remittance of the
tax.
MAIL OR DELIVER
Commissioner of the Revenue
101 Mounts Bay Rd., Bldg. B
FORM TO:
P.O. Box 283
Williamsburg, VA 23185
Williamsburg, VA 23187-0283
Phone: (757) 253-6698
* * * NO FAXED APPLICATIONS ACCEPTED * * *
August 2013

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