HomeMy WebLinkAboutHCTAT-REFUND REQUEST 10-4-2024FORM HCTAT-REFUND (10/2024)
PURPOSE OF VOUCHER
Effective January 1, 2022, the County of Hawai‘i
imposes a Hawai‘i County Transient Accommodations
Tax (HCTAT) at the rate of 3% on gross rental proceeds
and/or fair market rental value attributable to the County
of Hawai‘i. Use this form to request your refund.
COMPLETING THE VOUCHER
Print the name that is associated with your Hawai’i State
Tax ID account.
Fill in the period for the refund. Enter the date as
MM/DD/YY.
Enter your Hawai’i State Tax I.D. No. that starts with
TA, the 10-digit account number and the 2-digit
extension.
Enter your mailing address in the space provided (street
address, City, State, and zip code).
Enter your telephone number starting with the area
code.
Enter your email address (please print legibly).
Line 1. Enter the amount of refund requested.
Line 2. Select reason for refund. If selection is
“other” please provide reason in space provided.
*Please attach supporting documentation which may include: HCTAT-RV, Filed State TA-1/TA-2, payment receipts, or other documentation.
Processing of refunds may delayed or denied if adequate documentation is not included.
_______________________________________________________________________________________________
Name (Please print):_______________________________________________ Period Ending: __ __ / __ __ / __ __
Hawaii State Tax I.D. Number: TA – __ __ __ – __ __ __ – __ __ __ __ – __ __
Mailing Address: _________________________________________________________________________________ STREET UNIT TYPE/NO. CITY STATE ZIP CODE COUNTRY
Phone number: ( ) ___________________ Email address: ______________________________________
Line 1. Refund requested $
Line 2. Reason for refund (check reason for request):
☐ Annual Reconciliation (attach completed HCTAT-RV)
☐ Duplicate Payment (attach proof of duplicate payment)
☐ Wrong County (attach filed State form TA-1 or TA-2)
☐ Overpayment of Periodic Tax (attach filed State form TA-1)
☐ Other:
Printed Name: _______________________________________________________________________________________________
Signature: ______________________________________________________ Date: _________________________________
By signing this form, I attest under penalty of perjury that the above information is true and correct.
FORM
HCTAT-REFUND
(10/2024)
COUNTY OF HAWAI’I –– DEPARTMENT OF FINANCE
TRANSIENT ACCOMMODATIONS
TAX REFUND REQUEST VOUCHER