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TRANSIENT OCCUPANCY TAX REFUND REQUEST (Employee of a foreign government) Mail completed request to: City of Palmdale Finance Department 38300 Sierra Highway, Suite D Palmdale, CA 93550 This request must be mailed within 30 days of Hotel/Motel stay. I am an employee of a foreign government and I, hereby, request a refund of Transient Occupancy Tax in the amount of $ , paid to (name of hotel/motel) on (Date). I am claiming exemption under the legislative action cited below: I have attached a copy of my paid hotel/motel bill to substantiate this request for refund of paid transient occupancy taxes. I understand this request for refund must be filed directly with the City of Palmdale and the Hotel/Motel has no liability to assist me with this request. Note: Refund checks will be made payable to the qualifying company. Name of Qualifying Agency/Company Address of Qualifying Agency/Company ( ) Agency/Company Telephone number Signature of Individual Name of Individual Date