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2. 

4. Complete the form according to the instructions below. Print, sign, date and remit payment by check or money order to:

   Pitt County Tax Collector

   PO Box 875

   Greenville NC 27835 

   DO NOT SEND CASH. Reports must be filed or US postmarked on or before the twentieth (20th) of the month following the month in which the tax accrues. Taxes shown to be due including late penalties (if applicable) must be remitted with the report. Penalties will be imposed if payment is not paid when due.

6. Reporting Month
7. Year
8. Tax ID#
10. Owner Name
11. Mailing Address
13. Trade Name (DBA)
14. Street Address
16. Municipality
17. County Only

    1. Not located within a municipality
18. Contact Phone Number
22. LINE 1: Gross Retail Receipts (excluding sales taxes)
24. LINE 2: Sales Reported for online Travel Companies (OTC)
26. LINE 3: Less: Non-occupancy related receipts
28. LINE 4: Less: Occupancy receipts after 90 consecutive days
30. LINE 5: Net retail receipts subject to tax
32. LINE 6: Occupancy tax due (line 5 multiplied by 6%)
34. LINE 7: Penalty due (if applicable)
36. LINE 8: Credit Due (excess tax previously submitted)
38. LINE 9: Total Tax Due
40. CERTIFICATION & SIGNATURE*

    I certify this report is, to the best of my knowledge and belief, a true and complete report for the month indicated. (Once printed, please sign your name to the document before sending to Pitt County Tax Administration.)

    1. I agree.
42. Signature
43. Date:
    Date:
47. INSTRUCTIONS

    1. [LINE 1]: Enter gross retail receipts (includes all taxable & non-taxable receipts)
    2. [LINE 2]: Enter gross retail receipts reported from Online Travel Companies (OTC)/Facilitators
    3. [LINE 3]: Non-occupancy related receipts are receipts from retail sales that are not derived from rentals of any sleeping room or lodging furnished; receipts for which business did not collect a sale
    4. [LINE 4]: Occupancy receipts after 90 consecutive days are those receipts derived from the rental of a room(s) to the same person for more than 90 consecutive days of rental.
    5. [LINE 5]: Line 1 plus line 2 less lines 3 and 4.
    6. [LINE 6]: Line 5 multiplied by 6% (.06).
    7. [LINE 7]: Enter Line 6 multiplied by 5% if failure to file return is less than one (1) month. Add additional 5% or each additional month or fraction thereof. Add 10% of the tax for failure to pay tax
    8. [LINE 8]: Less taxes previously paid (Example: occupancy taxes already paid for rental originally intended for less than 90 consecutive days by extended beyond that time period).
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48. Print Only

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