Certificate Of Authority (Coa) Application To Collect Transient Occupancy Tax - San Francisco Office Of The Treasurer & Tax Collector
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2
3José Cisneros, Treasurer
Office of the Treasurer & Tax Collector
City and County of San Francisco
__________________________________________________________________________________________________________
CERTIFICATE OF AUTHORITY (COA) APPLICATION
TO COLLECT TRANSIENT OCCUPANCY TAX
Business Tax Section
P.O. Box 7425, San Francisco, CA 94120-7425
Taxpayer Assistance: (415) 554-4400
Part A: Hotel Operator Information
Ownership Name of Hotel Operator
1.
: _____________________________________________________________________
DBA Name
2.
: ____________________________________________________________________________________________
Business Certificate Number
3.
: ___________________________________________________________________________
Employer ID Number
4.
: Federal Employer Identification Number (FEIN) _____________________________________________
Social Security Number
____________________________________________
(Sole Proprietorships only)
Mailing Address:
5.
_____________________________________________________
________________________________________
Name of Contact Person
Title/Position
___________________________________________________________
_(____)__________________________________
Business Name
Telephone
___________________________________________________________
_(____)__________________________________
Street Address
FAX Number
___________________________________________________________
________________________________________
City
State
Zip Code
Email Address
Location of Accounting Records
6.
(if different from the mailing address):
_______________________________________________________________________
________________________________________
Name of Contact Person
Title/Position
_______________________________________________________________________
_(____)__________________________________
Business Name
Telephone
_______________________________________________________________________
_(____)__________________________________
Street Address
FAX Number
_______________________________________________________________________
________________________________________
City
State
Zip Code
Email Address
7. Ownership Information--indicate type of ownership, and provide names and contact information as noted:
Sole Proprietorship a) Type:
)
______________________________________________________ (Individual, Trust, Estate, Other
b) Provide residence address below.
Partnership
a) Type: _________________
(General, Limited Partnership, LLP, LLC, Joint Venture, Association, Other)
b) Provide names and contact information for all general partners
(attach additional sheets if
necessary)
Corporation
a) Sec. of State Corporate Identification Number
State:
___________________
___________
b) Provide names and contact information for all corporate officers and stockholders
owning 10% or more of shares
(attach additional sheets if necessary)
_______________________________________________________
For Partnerships: General Partner % Ownership _______________%
First Name
Middle Initial
Last Name
_______________________________________________________
For Corporations:
Corporate Officer ________________________
Stockholder, % Ownership _________________
Street Address
_______________________________________________________
City
State
Zip Code
_________________________
_(___)_______________________
Social Security Number
Telephone
_______________________________________________________
For Partnerships: General Partner % Ownership _______________%
First Name
Middle Initial
Last Name
_______________________________________________________
For Corporations:
Corporate Officer ________________________
Stockholder, % Ownership _________________
Street Address
_______________________________________________________
City
State
Zip Code
_________________________
_(___)_______________________
Social Security Number
Telephone
Hotel COA Application
Page 1 of 3
Rev. 4/11/12
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