Full Text
2. Allowable deductions/exemptions 2a. Rent for occupancies more than 30 days…. 2b. Rent for less than $2.00 per day 2c. Rent for medical reasons 2d. Rent for qualified Federal use 2e. Total reduction to gross receipts (lines 2a thru 2d) 3. Total taxable gross receipts for lodging (subtract line 2e from line 1) 4. Transient occupancy tax rate 5. Total tax due (multiply line 3 by line 4) 6. Delinquent tax due 7. Amount due before administrative fee (add line 6 to line 5) 8. Administrative expense rate 9. Administrative fee (ORS 320.345) (multiply line 7 by line 8) 10. Amount due after administrative fee (subtract line 7 from line 9) 11. Additions and adjustments 11a. Interest* 11b. Penalties** 11c. Adjustments (prior overpayment or other) 11d. Total additions and adjustments (lines 10a thru 10c) 12. Total amount due (add line 10 to line 11d) Please remit payments to: City of Woodburn Finance Department 270 Montgomery St Woodburn, OR 97071 Rev. 10-15 [EMAIL REDACTED] Checks for the total amount due (Line 10) are accepted by the Finance Department of the City of Woodburn only as the agent of the taxpayer and do not constitute payment until cleared. The City assumes no responsibility for loss of remittance in transit. Transient occupancy tax is due to the City on a basis no later than the 15th of the following month for the preceding month. (Ord. 2057, Sec 8(1)) Reporting Month/Year City of Woodburn Transient Lodging Tax Remittance Form - Transient Lodging Intermediaries Contact Person Phone Intermediary Name Address Email 1. Total gross receipts collected by intermediary (detailed on second page) * Interest is calculated at the rate of one percent per month without prorations for portions of a month, on the tax due, exclusive of penalties, from the date on which the tax first become delinquent until paid whether or not an extension has been granted to the intermediary. An intermediary who has not been granted an extension of time for remittance of tax due and who fails to remit the tax prior to delinquency (remittance of payment after the last day of the month the tax is due) shall pay a penalty of ten percent (10%) of the tax due in addition to the tax. An intermediary who has failed to pay a delinquent remittance before the expiration of 31 days following the date on which the remittance became delinquent shall pay a second delinquency penalty of fifteen percent (15%) of the tax due, the amount of the tax, and the ten percent (10%) penalty first imposed. (Ord. 2057, Sec 8(6) & Sec I declare, under penalty of making a false statement, that to the best of my knowledge and belief, the statements herin are correct. Signature Date Clear Fields $ 0.00 $ 0.00 $ 0.00 9.00% $ 0.00 $ 0.00 10.00% $ 0.00 $ 0.00 $ 0.00 $ 0.00 SIGN ---PAGE BREAK--- Reporting Month/Year Amount Total (reported on line 1 of page 1) 5 Remittance Form - Gross receipts collected by intermediary for each lodging entity Address Lodging Entity Name Lodging Entity Name Lodging Entity Name Lodging Entity Name City of Woodburn Transient Lodging Tax Lodging Entity Name Lodging Entity Name Address 6 1 2 3 4 Address Address Address Address $ 0.00