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                                                      Denver Lodger's Tax Return                                                                                                                                                   City and County of Denver
                                                                                                                                                      Quarterly                                         Department of Finance, Treasury Division
                                                                                                                                                                                                                                        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 Enterpaid directlyDIRECTbysalesthe exemptto Federal,organizationState, or Localfrom itsGovernmentalown funds anddepartmentsnot by theorindividualagencies,onanda reimbursementexempt charitable basis.organizations. Direct sales are those which are 
 NOTE:  byThisletterincludesfromanythe Denverbona fideDepartmentagencies ofofFederal,Finance,StateTreasuryor LocalDivision.GovernmentA copy  ofandthatthoseletterothershouldCharitablebe retainedOrganizationsin your fileswhichto substantiatehave been specificallythe exemption.exemptedA 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
                                                                                                                            7  Net Lodger's Tax (add lines 5 & 6) - - - - - - - - - - - - - ->
 B   Direct sales to Federal, State or Local                Governments                                              00                                                                                                                                      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
                                                                                                                                          if return is   A
 D   Bad Debts (Uncollectible Accounts, sales on which                                                               00      8               filed after          or $25.00 - - - - - - - - - - - - - - - - - - - ->
     Lodger's Tax was previously remitted) - - - - - - - - ->                                                                             due date-               Interest: 1% of Line 7 for each month                                                      00
                                                                                                                                               Add:      B
                                                                                                                                                                  that the return is late - - - - - - - - - - -->
   E Other (Documentation MUST be attached) - - - - - ->                                                             00                                                                                       Include a 
                                                                                                                                          Total Due and Payable (Add Lines 7, 8A & 8B): 
   F Total Deductions (Total of lines 3A thru 3E) - - - - - >                                                                9            check or moneyorder            made payable to MANAGER OF                                                          00
                                                                                                                     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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