HomeMy WebLinkAboutTOT Government ExemptCITY OF PALM DESERT
TRANSIENT OCCUPANCY TAX
GOVERNMENT EMPLOYEE EXEMPTION CLAIM
Government Agency
(Name of Department/Division/Agency/Country)
Employee Name
I certify under penalty of perjury, that the occupancy of the facilities above have been (or will be)
furnished for the exclusive use of and will be by the governmental agency named above and that such
charges are incurred in the performance of my official duties as a representative or employee of such
governmental agency.
Signature
Telephone
Title
Date
A SEPARATE EXEMPTION CERTIFICATE IS REQUIRED FOR EACH OCCUPANCYAND FOR EACH
REPRESENTATIVE.
Hotel/Motel Name
Dates of Occupancy
For Hotel Use
Clerk Verification Initials
Please verify each exempted government representative's valid identification or business
card by writing initials above.
Do Not send this form to the City. This form is to be retained by the Hotel/Motel operator for
no less than three years.
GovEmpExempt2012