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CITY OF UNALASKA
PO BOX 610 UNALASKA, AK 99685
Phone (907) 581-1251 Fax (907) 581-1417
www.ci.unalaska.ak.us
MONTHLY PREPAYMENT FORM
HOTEL / MOTEL TAX
YEAR: MONTH:
QTR1 o QTR2 o QTR3 o QTR4 o
QTR ENDING
March 31 June 30 September 30 December 31
NAME: BUSINESS LIC. #
ADDRESS:
A. DETERMINATION OF ADJUSTED GROSS RECEIPTS:
1. GROSS RECEIPTS FOR QUARTER (Including Hotel/Motel Tax collected) $ ________________________
2. NON-TAXABLE RECEIPTS (Complete Page 2) $ ________________________
3. ADJUSTED GROSS RECEIPTS (Subtract Line 2 from 1) $ ________________________
B. DETERMINATION OF TAXABLE RECEIPTS:
4. DIVIDE LINE 3 BY 1.05 (TAXABLE GROSS RECEIPTS) $ ________________________
C. DETERMINATION OF TAX DUE:
5. MULTIPLY AMOUNT OF LINE 4 BY .05 – HOTEL/MOTEL TAX DUE $ ________________________
6. DISCOUNT (If applicable, multiply Line 5 by .02) $ ________________________
7. NET PAYMENT DUE (Subtract Line 6 from Line 5) $ ________________________
To be eligible for the 2% discount, payment must be received at City Hall or postmarked on or before the 10th of the month
following the month that receipts were received. This report must be filed for each month in the quarter if discount is claimed
for any month. Quarterly Hotel/Motel Tax Reports must be filed at the end of each month in addition to prepayment forms.
I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT.
SIGNATURE TITLE DATE
PRINTED NAME EMAIL ADDRESS
COMPLETED HOTEL/MOTEL TAX REPORT MAY BE EMAILED TO CITY CLERK MARJIE VEEDER AT: mveeder@ci.unalaska.ak.us
