Form 1152
                       Travel and Convention Tax Return
                       Additional Page

                                                                      Permit number:

                                                                                      From:

                                                                                      To:

1.     2.              3.                           4.            5.                  6.                       7.
County Total Lodging   Less Nontaxable              Total Taxable Tax                 Tax                      Tax Due
Code   Sales           Sales           Lodging Sales              (column 4 x 2%)     Adjustments*             (columns 5 + 6)

*If you’re reporting adjustments in column 6, please provide a    Subtotal of column 7
letter with your return explaining the adjustments.               (carry forward to page 1, line 9) ...........
EFO00296     08-20-2021