Company Name:
Gross Receipts
Exempt Receipts
(Note A)
Balance
January 2020
February 2020
March 2020
Total
Total Room Tax Due
(3% of Total Balance)
Owner/Agent Signature
Contact Name:
Phone Number and/or email:
Please forward this report to the City of Hudson, Attn City Treasurer, 505 3
rd
St, Hudson
WI 54016, on or before April 30, 2020. Please make check payable to City of Hudson.
Please return this form with Payment.
For City Use Only
Receipt #:
Date:
CITY OF HUDSON
505 THIRD ST, HUDSON WI
Quarterly 3% Room Tax
Computation and Remittance Form for 1
st
Quarter 2020
Note A-Receipts from Organizations exempt from Wisconsin Sales Tax per Hudson Municipal
Code 218, Article II and Wisconsin State Statute 77.52 (2) (a).
I certify that the above figures are true and correct.
Dated this day of , 2020.
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
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