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” [email protected] www.TownOfMonroeAdamsCoWI.comTown of Monroe 981 County Rd Z Arkdale, WI 54613 Phone: 608-564-7271 Fax: 608-564-2283 Room Tax REMITTANCE ROOMDATE:(Required) MM slash DD slash YYYY Business Contact InfoName 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 35. GROSS TAX:(Required) 5% of Line 46. Delinquent filing fees/penalties(Required) TOTAL ROOM TAX DUE for Quarter:(Required) Line 5 + Line 6Choose 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 PAYMENTS1. 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 address3. WEBSITE: Submission of this Form & Payment can all be done electronically if desired from site4. CREDIT/DEBIT CARD: Go to Allpaid.com, use Code "a0055w" or use the link on our website5. NOTIFY TREASURER: Email (see below) any changes in Business name, address or the addition of any locationSubmitted by:(Required) Signature(Required) Δ