Please fill out the information below and upload the Hotel Room Rental Tax Remittance Report and the Exemption Statement.

After you have submitted your form, please continue to payment. Your submission will not be complete until both the documentation and payment have been received.

First Name *

Last Name *

Email Address*

Phone Number*

Facility Name*

Account Number*

Hotel Room Rental Tax Remittance Report *

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(DOC, DOCX, XLS, XLSX, TXT)

Exemption Statement Residency & Employment *

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)