TRANSIENT OCCUPANCY TAX REPORTING FORM Pursuant to La Quinta Municipal Code

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1 P.O. BOX CALLE TAMPICO L A QUINTA, CALIFORNIA FINANCE DEPARTMENT (760) FAX (760) TRANSIENT OCCUPANCY TAX REPORTING FORM Pursuant to La Quinta Municipal Code CERTIFICATE NUMBER: REPORTING PERIOD: 1. Gross rent for occupancy of rooms $ Allowable deductions: 2. Rent for occupancy by permanent residents $ 3. Exemptions $ 4. Credits $ 5. Total allowable deductions Lines 2 through 4 $ 6. Taxable rents: Line 1 minus Line 5 $ 7. Tax: 10% of Line 6 $ 8. Penalty, if applicable: See #3 of instructions $ 9. Interest, if applicable: See #4 of instructions $ 10. Amount due: Lines 7 through 9 $ * 10% rate effective October 3, 1991 I declare, under penalty of perjury, that to the best of my knowledge, the statements herein are true, correct and complete. Completed by: Signed: Title: Date: Tax is due IMMEDIATELY following the close of the reporting period shown above Delinquent of not paid within 30 days. Penalties assessed thereafter. Please complete this form and return with remittance to: City of La Quinta, FINANCE DEPARTMENT, P.O. Box 1504, La Quinta, California, TAX RETURN MUST BE FILED EVEN IF NO TAX IS DUE. CITY USE ONLY VALIDATION Date Paid: Check Number: Amount Paid: Checked By:

2 P.O. BOX CALLE TAMPICO L A QUINTA, CALIFORNIA FINANCE DEPARTMENT (760) FAX (760) TRANSIENT OCCUPANCY TAX REPORTING INSTRUCTIONS 1. EVEN IF THERE IS NO TAX DUE, a tax return must be filed with the Finance Department. 2. DELINQUENT DATE: The last day of the month following the close of the reporting period. 3. PENALTY: If paid within 30 days after delinquent date, 10% of the amount of the tax (Line 7). 4. INTEREST: In addition to penalty, ½ of 1% per month or fraction thereof, on the amount of the tax (Line 7) from delinquent date to date of payment. 5. REMITTANCE: Checks should be payable to City of La Quinta. Checks, drafts, postal notes and money orders are accepted by the Finance Department subject to collection and do not constitute payment until cleared. The City assumes no responsibility for loss in transit or delay in deposit. 6. RECEIPT: The canceled check becomes the receipt. No receipt will be mailed by the Finance Department unless demand for same is made at the time of payment. 7. ALL RECORDS SUBSTANTIATING THE RETURN must be retained by the operator for a period of not less than three (3) years from the date of payment. For allowable deductions, please refer to La Quinta Municipal Code Section et seq. 8. CHANGE OF OWNERSHIP OR ADDRESS must be reported immediately to the Finance Department. 9. UPON CESSATION OF BUSINESS FOR ANY REASON, returns and payments are due immediately to the Finance Department.

3 P.O. BOX CALLE TAMPICO L A QUINTA, CALIFORNIA FINANCE DEPARTMENT (760) FAX (760) TRANSIENT OCCUPANCY TAX REGISTRATION FORM Pursuant to La Quinta Municipal Code , et seq CERTIFICATE NUMBER (City Use): DATE: PLEASE PRINT OR TYPE ALL INFORMATION REQUESTED MUST BE PROVIDED 1. Name of Operator: 2. Operator s Title: 3. Business Name: 4. Business Street Address: City & State: Zip Code: Business Mailing Address: City & State: Zip Code: 5. Business Telephone Number: ( ) 6. Residence Address of Operator: City & State: Zip Code: 7. Residents Telephone Number of Operator: ( ) 8. Assessment Number of the last Riverside County Tax Bill covering this Business: 9. If Item 9 was not completed, the complete legal description of the real property upon which this business is located must be provided: 10. How long have you operated this business? 12. Type of Organization: Individual: Partnership: Corporation: Other (specify):

4 13. If Operator is not the Owner of the business, complete the following Owner s Name: Owner s Address: City & State: Zip Code: Owner s Telephone Number: ( ) 14. Names of Partners or Corporation Officers: Name: Title: Address: City & State: Zip Code: Name: Title: Address: City & State: Zip Code: Name: Title: Address: City & State: Zip Code: Completed By: Title: Signature: Date: Please send completed form & registration fee to: City of La Quinta Finance Department P.O. Box 1504 La Quinta, CA Registration Fee $5.00 CITY USE ONLY Date Paid: Amount Paid: $ VALIDATION Check Number: Checked By:

5 Business License No. OUT OF CITY BUSINESS LICENSE APPLICATION FORM (NON-VEHICLE) EVERY BUSINESS NOT HAVING A FIXED LOCATION WITHIN THE CITY OF LA QUINTA, WHO PROVIDE ANY SERVICES SHALL OBTAIN A CITY BUSINESS LICENSE. (Applies to those businesses that do not use vehicles in the actual performance of the service) LQMC *********************************************************************************** BUSINESS LICENSE APPROVAL: APPROVED BY DATE CLASS *********************************************************************************** 1. Business Name: 2. Business Address: City/State: Zip Code: 3. Mailing Address: City/State: Zip Code: 4. Business Phone: ( ) Address: 5. Owned by: Corporation: Partnership: Individual: 6. If Corporation or Partnership, Federal Tax I.D. is required: 7. Name of Owner or Officers and Title: 8. Type of Business 9. La Quinta Seller s Permit (SBER sale number): 10. IF REVENUE IS GENERATED WITHIN THE CITY OF LA QUINTA (Does Not Apply to Building Contractors): A. Estimated Gross Business Receipts for New Businesses Only: $ B. Previous Year Gross Receipts for Established Businesses: $ I HEREBY CERTIFY that all information supplied by me is correct and any licenses required by the County, State or Federal Government have been issued to me and are in full force and effect. Signature: Title: Date: Send Completed Form(s) to: CITY OF LA QUINTA BUSINESS LICENSE DIVISON P.O. Box 1504 La Quinta, CA (760)

6 GROSS RCEIPTS RANGE: CLASS 1 CLASS 2 CLASS ,000 $ $ $ ,001 50, , , , , , , , , ,001 1,000, ,000,001 2,000, ,000,001 3,000, ,000,001 4,000, ,000,001 5,000, , ,000,001 10,000,000 1, , , ,000,001 and up 1, , , CLASS 1 CLASS 2 Automobile Repair and Services: Laundry, Dry Cleaning and Garment Services; Manufacturing; Retail and Wholesale Trade. Amusement and Recreation Services, including Motion Pictures; Architectural Services; Automotive Sales; Barbers & Hairstylists; Beauty Shops; Engineering Services; Landscape to Buildings, and all other persons engaged in business not specifically listed elsewhere. CLASS 3 Accounting, Auditing & Bookkeeping Services; Financial Services, Insurance Brokers & Services; Legal Services; Management & Public Relations Services, Medical & Health Services; Real Estate Agents, Brokers, Managers & Services.

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