Form Sth20061 - County Lodging Tax Return Supplement

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STH
20061
Revised 10-2012
County Lodging Tax Return ‘Supplement’
E. Amended Return
A. Taxpayer FEIN/SSN
B. Reporting Period
C. Due Date
D. Account Number
H. Page ______ of _________ Page(s)
County Tax Schedule
M. Amount of Tax Due
K. Net Taxable Sales Subject
to Lodging Tax
(Multiply Item K by Item L)
L. Tax Rate
(%)
I. County Code
J. County Name
- - - Whole Dollars Only - - -
- - - Dollars - - -
Cents
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N. TOTAL County Tax (Line 16 through Line 40) (Add to Total on Item N. on Form STH20006)
If more space is needed, use supplemental page(s)

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