Hawaii Transient Accommodations Tax - Time Share Occupancy Registration (OBSOLETE)

Transient Accommodations Tax - Time Share Occupancy Registration (OBSOLETE)
Form TA-40, Rev 2011, Time Share Occupancy Registration Form
Clear Form

FORM TA-40

TRANSIENT ACCOMMODATIONS TAX

TIME SHARE OCCUPANCY
REGISTRATION FORM

Hawaii Tax I.D. No.

W __

  This Space For Office Use Only

STATE OF HAWAII — DEPARTMENT OF TAXATION

(REV. 2011)

__ __ __ __ __ __ __ - __ __

TYPE OR PRINT LEGIBLY
1.	 Type of application	   Original Application
		
  Amended Application      List line number(s) being changed:                 
2.	 Time Share Plan Manager’s Name			
3.  Doing business as (DBA) name
4.	

Mailing address 	

C/O		

Street address or P.O. Box		

City	

State Postal/Zip Code + 4

5.	

Physical location of business	

Street address				

City	

State Postal/Zip Code + 4

6.	

If no physical business location in Hawaii, provide the name, address, and telephone number of the individual performing services in Hawaii

7.	

Type of ownership	

  General Partnership	

  Corporation	

  LLC	

  Other (Explain)

	
		
  Sole proprietorship	   Limited Partnership	
  S Corporation	
  Single-Member LLC	
8.	 Phone Number	
Business	
Fax		
Residential		 E-mail address
		
(    )	
(    )	
(    )
9.	 Plan Manager’s Social Security Number	         10.  Federal Employer I.D. Number
11.	 List of owners, partners, principal corporate officers (Attach a separate sheet of paper if more space is required.)
	Social Security Number	
		

Name
	
Title	
Residential Address	
(Last, First, Middle Initial)
			

Business/Residential
Phone Number

(   )
(   )
(   )

12.	 Parent Corporation’s FEIN:	
13.  Parent Corporation’s Hawaii Tax I.D. No.	
14.  Date business began in Hawaii
W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
			       
/    /
15.	 Filing period:	   Monthly	
  Quarterly	
  Semiannually
Check monthly if you expect to pay more than $4,000 a year of Transient Accommodations Tax reported for the occupancy of time shares and all
time share plans within Hawaii;
Check quarterly if you expect to pay $4,000 or less a year in Transient Accommodations Tax reported for the occupancy of time shares and all time
share plans within Hawaii; or
Check semiannually if you expect to pay $2,000 or less a year in Transient Accommodations Tax reported for the occupancy of time shares and all
time share plans within Hawaii.
16.	 Accounting period, check only 1	   Calendar Year (The 12-month period from January 1 to December 31.)
			
  Fiscal Year ending   ___ ___ / ___ ___ (A 12-month period ending the last day of any month other than December.)
17.	 Registration Fee is $15.00 for each resort time share vacation plan in Hawaii.
	
a.  Enter number of resort time share plans in Hawaii that you represent. List the name, address, and the plan owner’s
		
Social Security Number (SSN) or Federal Employer I.D. Number (FEIN) of each plan on the back of this form.......................................17a
	
b.	 TOTAL AMOUNT DUE (Multiply line 17a by $15.00)
		
Pay in U.S. dollars drawn on any U. S. Bank to “HAWAII STATE TAX COLLECTOR”...................17b $

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Continue on back of this page.
CERTIFICATION: The above statements are hereby certified to be correct to the best of knowledge and belief of the undersigned who is duly authorized
to sign this application.

Signature of Owner, Partner or Member, Officer or Agent		

Print Name			 Title			Date	

	    This Space for Date Received Stamp			

— MAIL ONLY TO —
HAWAII DEPARTMENT OF TAXATION
P.O. Box 2430
Honolulu, HI 96804-2430

Daytime Phone Number: (

  

)				

FORM TA-40

FORM TA-40		
(REV. 2011)	
PAGE 2
18.	 Resort time share vacation plan information. List each resort time share vacation plan represented by you.
Plan No.
Assigned
by DCCA

Plan Name

Address

Plan Owner’s
SSN or FEIN

Check
if
NEW

Check Check
if
if
ADD CANCEL

   	
	
FORM TA-40