Lodging Tax Report Form - City Of Northport
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1
2CITY OF NORTHPORT
(205) 339-7000
Fax (205) 333-3046
LODGING TAX REPORT
_____________________
REPORTING PERIOD
MAIL THIS RETURN WITH REMITTANCE TO:
CITY OF NORTHPORT
P.O. BOX 569
Taxpayer ID:
NORTHPORT, AL 35476
NAME:
ADDRESS:
TOTAL AMOUNT ENCLOSED
$
PHONE:
□
□
Check here if this is a final return
Check here for additional forms
Out of Business Date: __________________
(A)
(B)
(C)
(D)
(E)
TAX AREA
GROSS TAXABLE
TOTAL
NET TAXABLE
TAX RATE
GROSS TAX DUE
AMOUNT
DEDUCTIONS
(Column A – Column B)
(Column C x Column D)
City
9%
Police Jurisdiction
4.50%
(1)Total Tax Due
th
(Total of Column E)
This return must be postmarked by the 20
day of the month
following the reporting period for which you are filing to be
(2)Penalty
considered a timely return.
(failure to file 10% OR $50.00 whichever
is greater AND failure to pay 10%)
By signing this report I am certifying that this report, including
(3)Interest
any accompanying schedules or statements, has been examined by
(Line 1 x 1% per month delinquent)
me and is to the best of my knowledge and belief, a true and
complete report for the period stated.
(4)Net Tax Due
(Add lines 1, 2 and 3)
Date__________________ Title__________________________
TOTAL AMOUNT DUE &
ENCLOSED
Signature_____________________________________________
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