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                                          Denver Lodger's Tax Return                                                                 Department of Finance,City and CountyTreasuryofDivisionDenver
                                                                                                 Quarterly 
                                                                                                                                                                    P.O. Box 660860 
                                                                                                                                                             Dallas, TX 75266-0860 
                                                                                                                                                          www.DenverGov.org/eBizTax 

Business Name                    Account Number                             Phone Number 
                                                                                                                u     YOU MUST FILE A RETURN EVEN IF YOU 
                                                                                                                      HAVE DETERMINED THAT NO TAX IS DUE 
Primary Business Location                                                   Period End Date                           IMPORTANT INFORMATION IS ON THE BACK
                                                                                                                u

** All entries on this Lodger's tax return must be rounded to the nearest dollar. You will still collect and keep track of exact amounts of sales tax. Books, records, and          ** 
   statements or invoices to buyers must reflect actual tax amounts. It is only when you fill out the return that you will round the numbers you are reporting. Round 
   amounts under 50 cents down to 0 (zero) cents. Increase amounts from 50 to 99 cents to the next dollar. 
Line 1  Enter gross receipts from all activities for the period. Do not include Lodger's Tax collected. 
Line 2a Enter collections during the period of bad debts which were deducted on Line 3d in a prior period. 
Line 2b Enter the total of Lines 1 and 2a. 
Line 3a Enter the receipts from non-taxable service or labor. Examples include valet and laundry charges, parking charges, health club fees, etc. 
Line 3b Enter DIRECT sales to Federal, State, or Local Governmental departments or agencies, and exempt charitable organizations. Direct sales are those which are 
        paid directly by the exempt organization from its own funds and not by the individual on a reimbursement basis. 
 NOTE:  This includes any bona fide agencies of Federal, State or Local Government and those other Charitable Organizations which have been specifically exempted 
        by letter from the Denver Department of Finance, Treasury Division. A copy of that letter should be retained in your files to substantiate the exemption. A letter 
        or number issued by the State of Colorado, or any other state, is not sufficient to allow a charitable exemption. 
Line 3c Enter sales to lodgers who have entered into a written binding agreement for a period of residency of 30 days or more. 
Line 3d Enter bad debts from uncollectible accounts for lodging written off during the period upon which tax was previously remitted to the City. 
Line 3e Enter any deductions which you are claiming with a complete description and attach related documentation. 
Line 3f Enter the total of Lines 3a thru 3e. 
Line 4  Enter the difference between Line 2b and Line 3f. 
Line 5  Multiply Line 4 by 10.75% and enter the result here. 
Line 6  If the amount of Lodger's Tax collected during the period exceeds the amount on Line 5, enter the excess amount on Line 6. 
Line 7  Enter the total of Line 5 and Line 6. 
Line 8A If the return is filed or paid after the due date, enter 15% of Line 7 or $25.00, whichever is greater. 
Line 8B If the return is filed or paid after the due date, enter 1% of Line 7 for each month or part of a month late. 
Line 9  Enter the the total of Lines 7, 8A and 8B. Include with your return a check or money order payable to   MANAGER OF FINANCE 

        q                                                                   RETURN LOWER PORTION - DETACH HERE                               q

      CHECK HERE IF THIS IS AN AMENDED RETURN                               DENVER LODGER'S TAX RETURN
Account Number         TaxType                       Period      End         Due Date   Media    # 
                       Lodger's Tax                                                         000000000004 
 NAME 
 PRIMARY BUSINESS LOCATION                                                                                                                     000000000004 
 PHONE NUMBER 
 I hereby certify, under penalty of perjury, that the statements made herein are to the best of my knowledge true and correct. 
 Signature (Required)                                                                   Title                                                        Date 
 1 Gross Receipts from Sale, Lease or Rental of                                  00     Net taxable sales of lodging (Line 2B minus line 3F) - >                                    00 
 Accommodations - - - - - - - - - - - - - - - - - - - - - - - - - - - >               4 
 2  A Add: Bad Debts collected which were previously                             00   5 Amount of Lodger's Tax (10.75% of Line 4) - - - - - - - >                                   00 
      deducted - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -> 
   B  Total of lines 1 and 2A - - - - - - - - - - - - - - - - - - - - >          00   6 Add Excess Tax Collected - - - - - - - - - - - - - - - - - - - > 
                                                                                                                                                                                    00 
3  A  Non-Taxable Service or Labor - - - - - - - - - - - - - - >                 00 
   B 
      Direct sales to Federal, State or Local Governments                        00   7 Net Lodger's Tax (add lines 5 & 6) - - - - - - - - - - - - - ->                             00
               and exempt Charitable  Organizations > 
   C  Accommodations for a period of 30 days or more ->                          00     Late Filing-      Penalty: the greater of 15% of Line 7                                     00 
   D  Bad Debts (Uncollectible Accounts, sales on which                                 if return is    A 
      Lodger's Tax was previously remitted) - - - - - - - - ->                   00   8 filed after       or $25.00 - - - - - - - - - - - - - - - - - - - -> 
                                                                                        due date-
   E  Other (Documentation MUST be attached) - - - - - ->                               Add:            B Interest: 1% of Line 7 for each month                                     00 
                                                                                                          that the return is late - - - - - - - - - - --> 
                                                                                 00 
                                                                                        Total Due and Payable  (Add Lines 7, 8A & 8B):  Include a 
   F  Total Deductions (Total of lines 3A thru 3E) - - - - - >                   00   9 check or money order made payable to   MANAGER OF                                           00
                                                                                        FINANCE 

                                                                                                                      00000000000400000000006 



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u Important Information: The City and County of Denver is now offering online filing for Sales, Use, Lodger's, 
  Occupational Privilege, Facilities Development Admissions, Telecommunications Business Tax, and Emergency 
  Telephone Charges (E911). For more information or to register online, visit www.DenverGov.org/eBizTax. 






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