State Retail License No. Tax Period
FEI or SS No. Due on or Before
Signature: Date:
Print Name & Title
City of Cayce
Enclose check made payable to the City of Cayce
Include your state retial l
icense number and the period covered on the check.
Per City of Cayce ordinance, a 2% Local Hospitality Tax on the gross proceeds from the sale of prepared
meals and beverages must be remitted to the City. The taxes are due on or before the twentieth (20th) of the
month following the close of the period. Please sign and date the return.
I hearby certify that all of the information state above is true and accurate to the best of my knowledge and belief.
1. Gross Sales: Prepared food and beverages
2. Hospitality Tax: Line 1 x 2% (.02)
3. Penalty on Deliquent returns: Line 2 x 5%(.05)
x _______________ number of months
4. Total Hospitality Tax Due (Add Lines 2 and 3
Local Hospitality Tax Reporting Form
Direct questions to (803) 550-9520
D/B/A Business Name and Location
Mail Forms and Payments to Hospitality Tax, 1800 12TH Street Ext. PO Box 2004, Cayce, SC 29171
Forms are available on our website at