Hotel Occupancy Tax Payment Report

Hotel Occupancy Tax Payment Report

Fill out your details and report your short-term rental revenue
Filing Period Start Date

MonthDayYear
Date
Filing Period End Date

MonthDayYear
Date
Full Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code

A report must be filed even if no tax is due

Rows	1. NUMBER OF ROOMS	2. LOCATION TRADE NAME AND ADDRESS	3. LOCATION NUMBER	4. TOTAL DOLLAR AMOUNT OF RECEIPTS	5. TOTAL TAXABLE RECEIPTS
Entry 1
Entry 2
Entry 3
Entry 4

6. Total room receipts (dollars) for ALL locations (column 4 from this and all supplemental pages)
7. Total taxable receipts (dollars) for ALL locations (column 5 from this and all supplemental pages)
8. Total Tax Due (Automatically Calculated)
Signature

Make this amount payable to

City of Melissa
Attn: Finance Dept.
3411 Barker Ave.
Melissa, TX. 75454

Should be Empty: