Charlottesville Transient Occupancy Tax

Please note: There is a dollar maximum for online payments. Anything over $10,000.00 (USD) will not be accepted by our payment processor. You must remit a check, bank draft or money order along with the return and postmarked by no later than the 20th of each month. Enter all account numbers carefully. Errors may cause payment rejection. Gross rental receipts not payout totals from 3rd party rental platforms are to be reported on Line #1.
Tax Year:  Tax Month:

 
   

Do you need to change your Business Information? Yes No

Business Information
1) Tax ID
2) Address:




City  State  Zip Code

3) Contact
Name Title
Phone Email



Legal Business Name Trade Name Account Number
     
 
Business Location Address

 


Transient Occupancy Tax Information
1) Monthly Gross Lodging Rentals (regardless of source/platform - total of all rentals) for month ending
 		 $
2) Exempt Rentals* (MUST INCLUDE DOCUMENTATION TO SUPPORT EXEMPT RENTALS)
Exemptions include stays of 30 or more nights and refunds of prior bookings 		$
3) Net Taxable Lodging Rentals: Line 1 (-) Line 2 0.00
4) Tax Due: Line 3 (x) 6% 0.00
5) Tax Remitted on Your Behalf by Third Party Intermediaries: TOTAL FROM BELOW 0.00
1. Online Platform / Intermediary
   Gross Receipts
$		 Tax Paid on Your Behalf
0.00 		click for additional entries
2. $ 0.00 click to delete entry
3. $ 0.00
4. $ 0.00
5. $ 0.00
6. $ 0.00
7. $ 0.00
8. $ 0.00
9. $ 0.00
10. $ 0.00
11. $ 0.00
12. $ 0.00

If you cannot provide documentation substantiating that tax was paid on your behalf by a lodging intermediary, it is your responsibility to pay the tax!
6) Net Tax Due: Line 4 - Line 5 0.00
7) Penalty for Late Payment: Line 6 (x) 5%, minimum $2.00 0.00
8) Interest 10% per annum of Line 6 + Line 7 0.00
9) Total Tax, Penalty, & Interest: Sum of Lines 6, 7, & 8 $0.00
If paying Transient Occupancy Tax with check:
Please mail documentation to support exempt sales with this filing form and check payable to:
City of Charlottesville, P.O. Box 2964, Charlottesville, VA 22902-2964

If paying Transient Occupancy Tax online:
Please e-mail documentation to support exempt sales to CORonlinepay@charlottesville.gov
Comments:



Pursuant to VA Code ยง 58.1-3906 Any corporate, partnership or limited liability company officer who willfully fails to pay, collect, or truthfully account for and pay over any local admission, transient occupancy, food and beverage, or daily rental property tax administered by the commissioner of revenue or other authorized officer, or willfully attempts in any manner to evade or defeat any such tax or the payment thereof, shall, in addition to other penalties provided by law, be liable for a penalty of the amount of the tax evaded or not paid, collected, or accounted for and paid over, to be assessed and collected in the same manner as such taxes are assessed and collected.

I declare that the foregoing statement and figures are true, complete, and correct to the best of my knowledge and belief.
Preparer
Last Name		First NameTitlePhoneE-mail

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Submit this form and pay the transient occupancy tax online. There is a 2.5% credit card fee and a $0.45 Electronic Check fee.


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