Alhambra Transient Occupancy Tax Application - exemption

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Alhambra Transient Occupancy Tax Application - exemption Powered By Docstoc
					                                             CITY OF ALHAMBRA
                                            FINANCE DEPARTMENT
                                          TRANSIENT OCCUPANCY TAX

EXEMPTION CERTIFICATE FOR GOVERNMENTAL AGENCIES-SEC.9-57 (1), (2)
AND (3) DATE: ________________________________________________________
TO: __________________________________________________________________

This is to certify that I, the undersigned, am a representative or employee of the governmental
Agency indicated below: that the charges for the occupancy at the above establishment on the
dates shown have been, or will be, paid for by such Governmental Agency directly; and that such
charges are incurred in the performance of my official duties as a representative or employee of
such Governmental Agency.

DATES OF OCCUPANCY __________________EXEMPTION AMOUNT ______________

NAME _____________________________________SS# _______________________________

TITLE ________________________________________________________________________

GOVERNMENTAL AGENCY ___________________________________________________

HOME OFFICE _______________________________________________________________

HOME OFFICE TELEPHONE (_____)-__________BUSINESS PHONE (____)-__________

NATURE OF OFFICIAL DUTIES ________________________________________________

SIGNATURE __________________________________________________________________

NOTE: Operators of Hotels, etc., should not accept this certificate unless the person presenting it shows
satisfactory credentials. A separate exemption certificate is required for each occupancy and for each representative.
All records shall be retained for a period of 3 years.

HOTEL REPRESENTATIVE ____________________________________________________

TITLE ________________________________________________________________________

IDENTIFICATION # ___________________________________________________________




THIS FORM IS TO BE EXECUTED AT THE TIME OF REGISTRATION. “SATISFACTORY
CREDENTIALS” MAY INCLUDE, BUT IS NOT LIMITED TO OFFICIAL GOVERNMENT
PHOTO IDENTIFICATION AND A LETTER ON OFFICIAL GOVERNMENT
LETTERHEAD SPECIFICALLY MENTIONING THAT THE PERSON PRESENTING THE
CERTIFICATE IS ON OFFICIAL GOVERNMENT BUSIENSS.

G:finrev/business license/totexemptcert

				
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