Short Term Rental Tax Quarterly Reporting Statement - Spotsylvania County
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1SPOTSYLVANIA COUNTY
Short Term Rental Tax
Acct # ________
Quarterly Reporting Statement
Commissioner of the Revenue
Reporting Quarter
Due Date
Deborah F Williams
Jan 1 to Mar 31
Apr 20
P O Box 175
Apr 1 to Jun 30
Jul 20
Spotsylvania, VA 22553
Jul 1 to Sep 30
Oct 20
(540) 582-7062 x 685
Oct 1 to Dec 31
Jan 20
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___________________________________
Owner’s Name
Name of Business
________________________________
___________________________________
Mailing Address
Physical Address (No P O Boxes)
________________________________
___________________________________
City
State
Zip
City
State
Zip
Social Security # _____/____/______
Federal ID # ___/________________
(
)____-_____
(
)____-_____
Owner’s Phone #
Business Phone #
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1. Total Gross Rental Proceeds for
_______________ to _______________ 20 ____
$_______________
Month
Month
Yr
2. Total gross rental proceeds exempt from Virginia Sales & Use Tax
$_______________
3. Taxable rental proceeds (Line 1 less Line 2)
$ _______________
4. Tax Due (Line 3 multiplied by 1%)
$ _______________
5. Late Payment Penalty (10% of tax due or $10, whichever is greater)
$ _______________
6. Total Tax and Penalty (Sum of Lines4 & 5)
* Interest will accrue at a rate 10% per annum
$ _______________
I hereby swear or affirm that the amounts listed above are true, correct and complete to the best of
my knowledge and belief for the period stated above.
______________________________________________________
____________________
Signature/ Title
Date
Phone No.
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FOR OFFICIAL USE ONLY
Date Reviewed _______________
By _______________
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