Room Tax Permit Application

Upon submitting this form you will receive a PDF copy of your submission via email.

"*" indicates required fields

Note: if you don’t have or know the information to put in the fields below, please insert “000”

Town of Monroe, Adams County, WI [email protected] www.TownOfMonroeAdamsCoWI.com

Town of Monroe

981 County Rd Z
Arkdale, WI 54613

Phone: 608-564-7271
Fax: 608-564-2283

Room Tax
Permit Application

Each Location: $50.00
Each Add'l Location: $25.00

DATE:*
MM slash DD slash YYYY

Business Contact Info

Name of Business*

Adams County Short Term Lic. #*

Contact Name*
First Last

State Lic. #*

Business Address*
Street Address City ZIP Code

Work #*

Mailing Address*
Street Address City ZIP Code

Home #*

Email Address:*

Cell #*

LIST Addresses for each location requiring a permit

LIST Addresses for each location requiring a permit*
Loc #
Address
Occupancy

* Required field. The cost of the first permit is $50.00. Each additional permit is $25.00

TOTAL DUE*
Please enter a number greater than or equal to 50.

Choose Payment Method:*

Cash

Check

Credit/Debit Card

Confirmation number:*
If paying with debit or credit card, first go to our website under Community tab > Online Payments to pay and get a confirmation number to complete this form.

Submitted by:*

Signature*

Room Tax Permit Application

Contact Information

Office Hours

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