Hotel Occupation Tax

2. Monthly Hotel Occupation Tax
   City of Fremont 400 E. Military Fremont, NE 68025-5141

   City of Fremont 400 E. Military Fremont, NE 68025-5141

4. Company Name*

6. Address*

8. City*

9. State*

10. Zip*

12. Contact Person*

14. Phone*

15. Fax

17. Email*

18. Date*

20. Reporting Period*
    -- Select One --Jan 2021Feb 2021Mar 2021Apr 2021May 2021Jun 2021Jul 2021Aug 2021Sept 2021Oct 2021Nov 2021Dec 2021

22. Taxable Sales per FMC 14-111 thru 113*

23. Occupation Tax Rate

25. Occupation Tax Due*

27. Plus Interest Penalties per FMC 14-116*

28. Total Amount to be Remitted*

30. Taxes are delinquent after the 25th day of the next succeeding month.

32. Name and Title*

34. Do You Agree?*

    1. I Agree

    By clicking "I agree," you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your "electronic signature" is valid and binding upon you to the same force and effect as a handwritten signature.

36. Online payment will be available on Friday of every week.

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38. 1. Receive an email copy of this form.
39. Email address

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40. Submit

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