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2. Date
   Date
4. Business Name
5. Quarter

   1. 1st Quarter, July - September, Due: October 30
   2. 2nd Quarter, October - December, Due: January 30
   3. 3rd Quarter, January - March, Due: April 30
   4. 4th Quarter, April - June, Due: July 30
7. Address
9. City
10. State
11. Zip
15. Completed return must be submitted with payment and received or postmarked by the due date.
17. 1. Maximum Number of Hotel Rooms (correct if total differs)
21. 2a. Total Occupied Room nights
23. 2b. Less: rooms occupied or leased for at least 30 days
25. 2c. Total Room Nights applicable for Tourism Assessment
27. 2d. Tourism Assesment Date (RAS# 5089)

    Multiply line 2c by tier rate:

    Tier Rate: Tier 1 ($2.15), 2 ($2.80), 3 ($3.15), 4 ($4.05)

29. 2e. Total Tourism Assessments Due
33. 3. Gross rent for occupancy of rooms
35. 4a. Less: Rent for occupancy of residents staying for at least 30 days
37. 4b. Less: Rent covered by Government Agency Exemption Certificates
39. 4c. Total Allowable Deductions
41. 5. Taxable Rents
45. 6. 12% Transient Occupancy Tax Due (RAS# 5081)
47. 7. Total Tourism Assessment & Transient Occupancy Tax Due
    Make payable to City of Watsonville
51. Complete section below only if return is past due.
53. 8a. 10% Penalty if postmarked 30 days past due
55. 8b. 10% Penatly if postmarked or received 31 or more days past due
57. 8c. 1/2% Interest per month or fraction thereof
59. 8d. Total Penalties & Interest
61. 9. Total Assessment, Transient Occupancy Tax and Penalities & Interest
65. Electronic Signature Agreement

    I represent, under penalty of perjury, that I am authorized to submit this tax remittance, that all above statements are true, correct and hereby authorize verification of these items. I acknowledge that this tax remittance is delinquent after 1 calendar month from the close of the quarterly reporting period and that the late penalties of 10% will be assessed on the tax balance due for the first and second monthly delinquency in addition to interest at 1/2% of the tax due per month, or fraction thereof, from delinquent date.
    
    I further agree to notify the Finance Department immediately of any changes of address and that if the business is disposed of or suspended a closing return must be filed immediately at City Hall (250 Main Street) with the applicable taxes due.
    
    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.
67. Electronic Signature
68. Date
    Date
70. Title
Leave This Blank:


72. 1. Receive an email copy of this form.
73. Email address

    This field is not part of the form submission.

74. Submit

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