Hotel And Motel Occupancy Tax Report Form - City Of Arlington
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1
2Hotel & Motel Occupancy Tax Report
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City of Arlington, Texas
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Reporting Period:
Account
QTR 1 (JAN FEB MAR) Due Apr 30
Name of Hotel / Motel
Number
QTR 2 (APR MAY JUN) Due Jul 31
QTR 3 (JUL AUG SEP) Due Oct 31
QTR 4 (OCT NOV DEC) Due Jan 31
Reporting
Hotel / Motel Address
Year
Hotel Occupancy Calculation Month:
Total
Month:
Month:
A
Total Gross Receipts
Federal Employee
B.1
Exemptions
State Official Exemptions
B.2
Permanent Resident
B.3
Exemptions
Total Allowable Exemptions
B
(B.1+B.2+B.3)
Net Taxable Receipts (A-B)
C
Total Tax Due 9% (C*.09)
D
0
0
0
0
Portion of Tax at 7% (C*.07)
E
0
0
0
0
Portion of Tax at 2% (C*.02)
F
0
0
0
0
Failure to pay by the due date will result in a 5% penalty. An additional penalty of 5% of the tax due shall be paid if the tax is not paid
within 30 days from the date the tax was due. Another penalty of 5% of the tax due shall be paid if the tax was not paid within 60 days
from the date the tax was due. Delinquent taxes shall draw interest at 10% per annum beginning 60 days from the date the tax was due.
Exemption Calculations
Month:
Month:
Month:
Online Travel Company
Yes
Total number of Rooms
G
Indicate with "Yes' or "No" if
in Property
any of the above calculations
Permanent Resident
were transactions made with
H
Occupied Rooms
or through an Online Travel
Company (OTC). And, if yes,
% of Units Occupied by
include with this report the
I
0
0
0
Permanent Residents
Hotel/Motel Tax Report
No
Regarding Sales Involving
Room Nights Rented
J
OTC. (See Page 2)
Excluding Exemptions
I,
certify by signing below that the above information is true and correct as shown in the records of
(Printed name of person completing this form)
Check #:
Amount Remitted:
.
(Printed name of Hotel, Management Company, etc)
Signature:
Date:
Phone:
E-Mail:
.
Return this form and payment to:
For questions please contact:
Please be advised that it is an offense if an owner of a hotel: fails to collect
City of Arlington - Treasury Division
817-459-6268
the tax imposed; fails to file a report as required; fails to pay the tax when
P.O. Box 90231 - MS 63.0820
Monday to Friday
payment is due; or files a false report. These offenses are punishable by a
Arlington TX 76004.3231
8:00AM - 5PM
fine not to exceed $500.
For additional copies of this form and additional information, please visit our website:
Form Revised July 2012
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