Form 12-100 - Texas Hotel Occupancy Tax Report
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1
212-100
Be sure to print and sign your return.
b.
RESET FORM
PRINT FORM
(Rev.11-12/22)
under Chapters 552 and 559, Government Code,
Texas Hotel Occupancy Tax Report
You have certain rights
to review, request and correct information we have on file about you.
Contact us at the address or phone number listed on this report.
75100
Page 1 of ______
a. T Code
e.
c. Taxpayer number
d. Filing period
f. Due date
IMPORTANT
g. Name and mailing address (Make any necessary name changes below.)
h.
Blacken this box if any preprinted
1.
information has changed. Show changes
beside the preprinted information.
Blacken this box if any location shown is no
2.
longer in business. Write the location number
and the date you went out of business below.
LOCATION
OOB
NUMBER
DATE
i.
j.
- A report must be filed even if no tax is due.
- Do not write in shaded areas.
1.
3.
4.
5.
2.
NUMBER
LOCATION
TOTAL ROOM
TOTAL TAXABLE
LOCATION TRADE NAME AND ADDRESS
OF ROOMS
NUMBER
RECEIPTS
RECEIPTS
75180
k. T Code
6.
6. Total room receipts for ALL locations (Item 4 from this and all supplemental pages)
7.
7. Total taxable receipts for ALL locations (Item 5 from this and all supplemental pages)
8.
8. Total tax due (
% of Item 7)
9.
9. Discount (If paid on time, enter 1% of Item 8)
10.
10. Tax due after discount (Item 8 minus Item 9)
12-100
(Rev.11-12/22)
11.
11. Penalty (See instructions)
12.
12. Interest (See instructions)
13.
13. TOTAL AMOUNT DUE AND PAYABLE (Item 10 plus Item 11 and Item 12)
Taxpayer name
l.
m.
T Code
Taxpayer number
Period
I declare that the information in this document and any attachments is true
and correct to the best of my knowledge and belief.
Duly authorized agent
Make the amount in Item 13 payable to:
STATE COMPTROLLER
Mail to: Comptroller of Public Accounts
Daytime phone
Date
(Area code and number)
P.O. Box 149356
Austin, TX 78714-9356
For assistance call
or
.
1-800-252-1385
512-463-4600
111 A
Details are also available online at
.
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