Transient Occupancy Tax
Account # ____________
Spotsylvania County, Virginia
Deborah F Williams, Commissioner of Revenue
PO Box 175, 9104 Courthouse Rd, Spotsylvania VA 22553-0175
Complete Sections A, B & C.
File on or before the last day of the month following the month being reported.
In person – Deliver to our office by 4:30pm on the last day of each month.
– Postmark on or before the last day of each month.
Make check payable to: Treasurer, Spotsylvania County
Mail to: Attn: Transient Occupancy 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
Block / Street Name
Block / Street Name (No PO Boxes)
Social Security #
B. Calculating Tax
Total Gross Receipts for the Month of
Less Allowable Deductions
(If rental exceeds 30 consecutive days or more, it is exempt from tax.) (If Zero, enter “0.”)
Taxable Gross Receipts (Subtract Line 2 from Line 1)
Calculate Tax - 5% of Gross from Line 3 (Multiply Line 3 by 5%)
Late Payment Penalty (If late, Multiply Line 4 by 10%)
Interest (Accrues at rate of 10% per year)
*Interest will begin to accrue after the last day of the month following the due date.
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
For Office Use Only
(Online Form - rev 12/19/12
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