Form Ta-40 - Time Share Occupancy Registration Form

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FORM TA-40
This Space For Office Use Only
STATE OF HAWAII — DEPARTMENT OF TAXATION
TRANSIENT ACCOMMODATIONS TAX
(REV. 2011)
A
A
TIME SH
RE OCCUP
NCY
A
REGISTR
TION FORM
Hawaii Tax I.D. No.
W
__ __ __ __ __ __ __ __ - __ __
TYPE OR PRINT LEGIBLY
1.
Type of application
Original Application
Amended Application
List line number(s) being changed:
2.
Time Share Plan Manager’s Name
3. Doing business as (DBA) name
4.
Mailing address
C/O
Street address or P.O. Box
City
State Postal/Zip Code + 4
5.
Physical location of business
Street address
City
State Postal/Zip Code + 4
6.
If no physical business location in Hawaii, provide the name, address, and telephone number of the individual performing services in Hawaii
7.
Type of ownership
General Partnership
Corporation
LLC
Other (Explain)
Sole proprietorship
Limited Partnership
S Corporation
Single-Member LLC
8.
Phone Number
Business
Fax
Residential
E-mail address
(
)
(
)
(
)
9.
Plan Manager’s Social Security Number
10. Federal Employer I.D. Number
11. List of owners, partners, principal corporate officers (Attach a separate sheet of paper if more space is required.)
Name
Business/Residential
Social Security Number
Title
Residential Address
(Last, First, Middle Initial)
Phone Number
(
)
(
)
(
)
12. Parent Corporation’s FEIN:
13. Parent Corporation’s Hawaii Tax I.D. No.
14. Date business began in Hawaii
W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
/
/
15. Filing period:
Monthly
Quarterly
Semiannually
Check monthly if you expect to pay more than $4,000 a year of Transient Accommodations Tax reported for the occupancy of time shares and all
time share plans within Hawaii;
Check quarterly if you expect to pay $4,000 or less a year in Transient Accommodations Tax reported for the occupancy of time shares and all time
share plans within Hawaii; or
Check semiannually if you expect to pay $2,000 or less a year in Transient Accommodations Tax reported for the occupancy of time shares and all
time share plans within Hawaii.
16. Accounting period, check only 1
Calendar Year (The 12-month period from January 1 to December 31.)
___ ___ / ___ ___ (A 12-month period ending the last day of any month other than December.)
Fiscal Year ending
17. Registration Fee is $15.00 for each resort time share vacation plan in Hawaii.
a. Enter number of resort time share plans in Hawaii that you represent. List the name, address, and the plan owner’s
Social Security Number (SSN) or Federal Employer I.D. Number (FEIN) of each plan on the back of this form ......................................17a
TOTAL AMOUNT DUE
b.
(Multiply line 17a by $15.00)
$
Pay in U.S. dollars drawn on any U. S. Bank to “HAWAII STATE TAX COLLECTOR” ..................17b
Â
Continue on back of this page.
CERTIFICATION: The above statements are hereby certified to be correct to the best of knowledge and belief of the undersigned who is duly authorized
to sign this application.
Signature of Owner, Partner or Member, Officer or Agent
Print Name
Title
Date
This Space for Date Received Stamp
(
)
Daytime Phone Number:
— MAIL ONLY TO —
HAWAII DEPARTMENT OF TAXATION
P.O. Box 2430
Honolulu, HI 96804-2430
FORM TA-40

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