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(Inputs in white areas only) Schuyler County - Treasurer's Office 105 9th Street - Unit 17 Watkins Glen, NY 14891 (607) - 535-8181 Certificate of Registration and Application for Certificate of Authority to Collect Hotel Room Occupancy Tax All questions MUST be answered Please Print or Type (Insert Federal I.D. Number in Box) 1. Business Name: (Individual, Trade Name, or Corporate Name) 2. Mailing Address: (Street) (City) (State & Zip) 3. Business Location: (Street) (State & Zip) 4. Phone: (City) Email address: 5. List below Name and Home Address of Individual, Partners or Principal Officer: (Name) (Home Address) (Title) Hotel Motel B&B Other 6. Number of Bedrooms: 7. Type of Establishment: 8. Type of Ownership: Individual Partnership Corporation 9. Exact date of first rental as business in Schuyler County: 10. If acquired from former owner: Name under which it operated previously: Former Owners Registration Number: I hereby certify that the statements made herein have been examined by me, and are to the best of my knowledge and belief, true and complete. Name: Title: I.D.No. (SSN or TIN): Date: Booking exclusively through Airbnb: (Y or N )