FORM TA-1
(Rev. 2018)
Form TA-1
Page 2 of 2 20
17. FOR LATE
PENALTY
FILING ONLY
INTEREST
17.
18. TOTAL AMOUNT DUE AND PAYABLE (Original Returns, add lines 11 and 17;
Amended Returns, add lines 16 and 17) ........................................................................................ 18.
19. PLEASE ENTER THE AMOUNT OF YOUR PAYMENT. Attach a check or money order
payable to “HAWAII STATE TAX COLLECTOR” in U.S. dollars drawn on any U.S. bank to
Form TA-1. Write “TA,” the filing period, and your Hawaii Tax I.D. No. on your check or money order.
Mail to: HAWAII DEPARTMENT OF TAXATION, P. O. Box 2430, HONOLULU, HI 96804-2430
or file and pay electronically at tax.hawaii.gov/eservices/. If you are NOT submitting a
payment with this return, please enter “0.00” here. ...................................................................19.
PART V — TOTAL AMOUNT DUE
DISTRICT
/ ED CODE AMOUNT
DISTRICT
/ ED CODE AMOUNT
DISTRICT
/ ED CODE AMOUNT
Grand Total of Exemptions and Deductions — Add the amounts above in Part VI and enter here. If more space is needed,
attach a schedule. Include the total deductions claimed from any attachments in this total. (See Instructions) ..........................
PART VI — SCHEDULE OF EXEMPTIONS/DEDUCTIONS
Note: Most ordinary business expenses are NOT DEDUCTIBLE (e.g., materials, supplies, etc.) on your transient accommodations tax return. For more information, see
the Form TA-1 Instructions.
You must explain your exemptions and deductions, otherwise they will be disallowed and you will owe more taxes.
Additional Instructions for Exemptions/Deductions (ED)
For each exemptions/deductions you have claimed, enter:
1. For the “DISTRICT” column, enter the number that represents the Tax District from which the income was earned.
1 = Oahu; 2 = Maui; 3 = Hawaii; and 4 = Kauai
2. For the ED Code please see the list of codes below and enter the corresponding Exemption/Deduction code.
3. Enter your total amount of the exemption/deduction claimed for that District and ED Code.
Example: Taxpayer A received gross rental proceeds of $2,000.00 from the Consul General of the Philippines for lodging on Maui. Taxpayer A
enters the following to justify the deduction entered in Part I, Line 2, Column b of the Transient Accommodations Tax Return:
DISTRICT / ED CODE AMOUNT
2/110 !!!,!!2,000
.
00
Description (HRS) ED Code Description (HRS) ED Code Description (HRS) ED Code
Complimentary Accommodations
(§237D-3(7)) .....100
Diplomats and Consular Ofcials
(§237D-3(8)) ...... 110
Federal or state subsidized lodging
(§237D-3(5)) .................................................120
Health care facilities dened in HRS§321-11(10)
(§237D-3(1)) .................................................130
Nonprot Organization, Lodging provided by a
(§237D-3(3)) .................................................140
School Dormitories (§237D-3(2)) .......................150
Students —
Full-time Post-secondary (§237D-3(6)) ........160
Summer Employment (§237D-3(6)) .............170
Temporary Lodging Allowance for military
(§237D-3(4)) .................................................180
Working Fringe Benet (§237D-3(7)) ................190
Name:___________________________________________________
Hawaii Tax I.D. No.
Last 4 digits of your FEIN or SSN
PERIOD ENDING (MM/YY)
PART VI — SCHEDULE OF EXEMPTIONS/DEDUCTIONS
Note: Most ordinary business expenses are NOT DEDUCTIBLE (e.g., materials, supplies, etc.) on your transient accommodations tax return. For more information, see
the Form TA-1 Instructions.
You must explain your exemptions and deductions, otherwise they will be disallowed and you will owe more taxes.
TA1_F 2018A 02 VID01
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