County of Fulton
County Treasurer’s Office
E. Terry Blodgett, Treasurer 223 W. Main Street, Room 202 Phone: (518) 736-5580
Michelle Ippoliti, Deputy Treas. P.O. Box 128 Fax: (518) 736-1794
Felicia Duesler, Asst. Deputy Treas. Johnstown, NY 12095 Email: fctreasurer@fultoncountyny.gov
INSTRUCTIONS FOR ROOM OCCUPANCY TAX RETURN FORM
1. Provide the Identification Number assigned on the Certificate of Authority
2. Business or Owner Name
3. Contact Name
4. Address of rental property for which this return is being filed
5. Telephone number where you can best be reached
6. Email address where you can best be reached
7. Mailing Address where all correspondence should be sent, if different from Business Address
8. Quarterly Reporting Period for which you are submitting payment (for Final Returns, provide
reason for the final return. If property sold, provided date sold and new owner contact
information)
9. Type of Business/Ownership of the property
10. Number of Rental Units Available
11. If you use Airbnb, provide the GROSS income received for the quarter.
COMPUTATION OF TAX AMOUNT PAID (please complete the fields in yellow).
1. Revenue from room rental only (do not include any taxes or fees charged). This is for any income
received EXCLUDING INCOME RECEIVED THROUGH AIRBNB listed above.
2. Any Non-Taxable Room Rentals (to be used for any rentals that were exempt from paying taxes)
3. Net Taxable Room Rentals (Line 1 – Line 2)
4. Room Occupancy Tax Owed (4% of Net Taxable Room Rentals on Line 3)
5. Overpayment/Underpayment from any Prior Return of Tax on Room Occupancy, if any (when
reporting an overpayment, please enter a minus sign before the number)
6. A Penalty of 5% is charged on taxes due that are not paid or postmarked by the 20
th
day following
the month taxes are due. (5% of the amount reported on Line 4)
7. Interest of 1% per month is charged as an additional penalty if payment is made more than 30
days after the end of the period being paid (i.e. if a tax is due by 4/20, but is made after 5/20, an
additional 1% interest penalty is due on the amount reported on Line 4. Interest will continue to
accumulate for each month the payment is late until it is paid.)
8. Operator Collection Credit of 5% - up to $200 (5% of Line 4)
9. The Total Amount Due is Line 4 +(or -) Line 5 + Line 6 + Line 7 – Line 8 *
*(If Total Amount Due is a credit balance, this amount should be deducted from your next return
on Line 5 as an overpayment.)
Make checks Payable to “FULTON COUNTY TREASURER” and mail it with the return form to:
223 W. Main Street, Room 202
P.O. Box 128
Johnstown, NY 12095
Sign and date the Return Form certifying the statements as completed.
