Room Tax Remittance Form

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

Note: if you don’t have 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
REMITTANCE ROOM

DATE:(Required)
MM slash DD slash YYYY

Business Contact Info

Name of Business(Required)

Room Tax Permit #(Required)

Location Name:(Required)

Phone(Required)

Location Address:(Required)

Mailing Address:(Required)

Email Address:(Required)

QUARTER Ending:(Required)
3/31
6/30
9/30
12/31
Tick appropriate check box:

1. Gross Receipts(Required)

2. Non-Transient room Receipts(Required)

3. Non-Taxable room Receipts *(Required)
* NOTE: Non-Taxable Room receipts are for government, schools, religious and other non-taxable entities. (See Wis. §66.0615 (2M) §77.54 (9a))

4. Taxable room Receipts(Required)
Line 1 - Line 2 - Line 3

5. GROSS TAX:(Required)
5% of Line 4

6. Delinquent filing fees/penalties(Required)

TOTAL ROOM TAX DUE for Quarter:(Required)
Line 5 + Line 6

Choose Payment Method:(Required)

Cash

Check

Credit/Debit Card

Confirmation number:(Required)
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.

HANDLING OF FORMS AND PAYMENTS

1. Payment DUE: On the last day of the month following the quarter being reported. See Room Tax Ordinance on website for "Monroe Ordinance Number 2021-1" for late Penalties and Interest Percentages

2. MAIL: Print & mail completed Remittance Form & Payment to: Town of Monroe, Treasurer at above address

3. WEBSITE: Submission of this Form & Payment can all be done electronically if desired from site

4. CREDIT/DEBIT CARD: Go to Allpaid.com, use Code "a0055w" or use the link on our website

5. NOTIFY TREASURER: Email (see below) any changes in Business name, address or the addition of any location

Submitted by:(Required)

Signature(Required)

Contact Information

Office Hours

Transfer Site