Form 150-604-001 - State Of Oregon Lodging Tax Registration - 2013 Page 2

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Multiple Vacation Rental Properties Listings
BIN: __________________
Name of facility:
________________________________________________
Name of facility:
________________________________________________
(if applicable)
(if applicable)
Physical address: ________________________________________________
Physical address: ________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Region (circle):
1
2
3
4
5
6
7
8
9
10
Region (circle):
1
2
3
4
5
6
7
8
9
10
Name of facility:
________________________________________________
Name of facility:
________________________________________________
(if applicable)
(if applicable)
Physical address: ________________________________________________
Physical address: ________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Region (circle):
1
2
3
4
5
6
7
8
9
10
Region (circle):
1
2
3
4
5
6
7
8
9
10
Name of facility:
________________________________________________
Name of facility:
________________________________________________
(if applicable)
(if applicable)
Physical address: ________________________________________________
Physical address: ________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Region (circle):
1
2
3
4
5
6
7
8
9
10
Region (circle):
1
2
3
4
5
6
7
8
9
10
Name of facility:
________________________________________________
Name of facility:
________________________________________________
(if applicable)
(if applicable)
Physical address: ________________________________________________
Physical address: ________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Region (circle):
1
2
3
4
5
6
7
8
9
10
Region (circle):
1
2
3
4
5
6
7
8
9
10
OREGON’S TEN REGIONS
Name of facility:
________________________________________________
1. North Coast
4. Willamette Valley
8. Mt. Hood / Gorge
(if applicable)
2. Central Coast
5. Portland Metro
9. Northeastern
3. South Coast
6. Southern
10. Southeastern
Physical address: ________________________________________________
7. Central
________________________________________________
Astoria •
5
1
________________________________________________
Pendleton •
The Dalles •
Tillamook •
Portland •
8
Region (circle):
1
2
3
4
5
6
7
8
9
10
Oregon City •
La Grande •
9
Salem •
Newport •
Baker City •
Corvallis •
Madras •
4
Name of facility:
________________________________________________
Prineville •
Eugene •
7
(if applicable)
Bend •
Ontario •
2
• Cottage Grove
Reedsport •
Physical address: ________________________________________________
Coos Bay •
Burns •
________________________________________________
Roseburg •
________________________________________________
10
3
Jordan Valley •
6
Port Orford •
Region (circle):
1
2
3
4
5
6
7
8
9
10
Medford •
Klamath Falls •
Brookings •
150-604-001 (Rev. 03-13)
If additional space is needed, please attach as many sheets as necessary.

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