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2. 
4. Monthly Motel Accommodations Tax Remittance Form
   Village Code, Section 37.111 provides for the imposition of a hotel/motel tax upon the rental or leasing of any hotel or motel accommodations in the Village at the rate of five (5) percent of the gross rental or leasing charge.
6. Due by the 20th of the month following the monthly liability period.
10. Owner/Corporate Name*
11. Monthly Liability Period*
13. Address*
    City, State, Zip
15. Is this an AMENDED RETURN?*

    1. Yes
    2. No
17. STEP 1: Write your taxable receipts.
19. 1. Total receipts (include tax)*
    Same as State RHM-1 line 1
21. STEP 2: Figure your deductions.
23. 2. State tax deduction*
    Same as State RHM-1 line 8
25. STEP 3: Figure taxable base.
27. 3. Taxable base*
    Subtract Line 2 from Line 1
29. STEP 4: Figure your tax.
31. 4. Village Tax*
    Multiply line 3 by .05
33. STEP 5: Figure your payment due.
35. 5. Village Tax *
    Line 4 above
37. 6. Late penalty after 20th of month*
    Multiply line 5 by .10
39. 7. Payment amount due*
    Add line 5 + line 6
41. Village Code, Section 37.115 states that if for any reason tax is not paid when due, a penalty at the rate of two (2) percent per month on the amount of tax which remains unpaid shall be added and collected. Taxes are due by the 20th of the month following the monthly liability period.
45. Under penalties of perjury and other penalties provided by law, I state that I have examined this return and, to the best of my knowledge and belief, it is true, correct and complete. The information in this return is taken from the records of the business for which it is filed.
47. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
49. Paid preparer's signature*
50. Date*
    Date
51. Phone*
53. Taxpayer's signature*
54. Date*
    Date
55. Phone*
57. 
Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field