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Reporting Information

Title II Compliance
In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website.
Quarterly reports and payments are delinquent unless they are either paid in our office or postmarked by the last day of the month following the end of the quarterly report period. Retain copy of this printed form for your records.
Make Checks Payable To
City of Modesto, P.O. Box 3442, Modesto, CA 95353
Do You Need to Report a Change of Ownership?*
1. Yes
2. No
Reporting Ownership Change
1. I understand change of ownership must be filed and reported immediately to the finance department.
For additional information, please call 209-577-5389.
Reporting Period*
1. January 1st to March 31st
1. April 1st to June 30th
1. July 1st to September 30th
1. October 1st to December 31st
Are you currently delinquent on paying your Transient Occupancy Taxes?*
1. Yes
2. No
1. No Sure
Is this a final return?*
1. Yes
2. No
Reporting Within Thirty Days
1. I understand that if business is disposed of or suspended, final return must be filed and tax and fee due paid within thirty (30) days even if there is no tax or fee due.
For additional information, please call 209-577-5389.
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Occupancy Information

Number of Rooms*
Percent of Occupancy*
Gross Rent for Occupancy of Rooms*
Do you need to enter any allowable deductions?*
1. Yes
2. No
1. Unsure
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Calculation of Taxes

Rent for Occupancy by Permanent Residents *
Enter amount of rent collected by those who have signed an agreement to rent for more than 27 consecutive days.
(Used to Calculate Allowable Deductions)
Rent Covered by Exemption Certificates*
A copy is required to be submitted with this form in order to claim deduction.
(Used to Calculate Allowable Deductions)
Total Allowable Deductions*
Used to Calculate Tax Due
Taxable Rents*
Equal to Gross Rent for Occupancy of Rooms subtracted by allowable deductions.
Taxable Rents*
Equal to Gross Rent for Occupancy of Rooms.
Tax Due*
Equal to Taxable Rents multiplied by 9% (0.09). Enter 0 if there is no tax or fee due. A return must be filed with the Finance Department even if no tax or fee is due.
Fee Due*
Equal to Taxable Rents multiplied by 1% (0.01). A return must be filed with the Finance Department even if no tax or fee is due.
Penalty Due*
If applicable. Penalty is 5% times number of months or fraction of month of delinquency to a maximum of 25% of tax due and fee due.
Total Tax and Fee Due*
Equal to total of Tax plus Fees plus Penalties (if applicable)
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Acknowledgement & Signature

Business Name*
Your Title*

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Transient Occupancy Tax Quarterly Report

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Reporting Information

Occupancy Information

Calculation of Taxes

Acknowledgement & Signature

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