HomeMy WebLinkAboutTOT 31 Day Exempt
CITY OF PALM DESERT–FINANCE DEPARTMENT
TRANSIENT OCCUPANCY TAX OVER 30 NIGHTS
EXEMPTION FORM
In order to qualify for an over thirty night exemption this form must be completed in full by the operator and signed by the
occupant, prior to occupancy. Absent such obligatory agreement, occupant is deemed to be a transient and subject to the City’s
Transient Occupancy Tax for exercising occupancy for a period of thirty consecutive calendar nights or less. Please print or
type in ink.
Occupant Name:________________________________________________
Room Rate$________________ Daily _______ Weekly ______ Monthly_________
Room Number _________________ (attach listing if multiple rooms)
Period of Residency From Date: ______________________________ Thr ough Date:________________
A. The UNDERSIGNED hereby request to be exempted from paying Transient Occupancy Tax in the amount of
$ because the tenancy is for more than thirty consecutive calendar nights.
B. $ X =
Daily Room Rate Number of Nights Subject
to TOT exemption
Total Rent Subject to
TOT exemption
Total Rent
OCCUPANT AFFIDAVIT:
X 11% =
TOT Rate
Total TOT Tax subject
to exemption
I hereby certify that I have been exempted transient occupancy tax in the amount of $ I understand that
this agreement obligates me to pay rent to the hotel/motel operator for the right of exercising occupancy in excess of thirty
(30) consecutive nights. Although I may not exercise occupancy for a period in excess of thirty (30) consecutive nights, I shall
be liable to the operator for rent for the period of time agreed upon. I declare under penalty of perjury that to the best of my
knowledge and belief the statements made herein are correct and true.
Signature of Occupant Date
Telephone Number
FOR OPERATOR USE ONLY
Operator Note: Exemption is granted to occupant. This form must be signed by the occupant. Make copy and provide
occupant with photocopy. Operator must file and maintain original for minimum of three years.
Name of Hotel/Motel Operator
Name of Hotel/Motel Employee