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2. REGISTRATION FOR THE
   LANCASTER COUNTY HOTEL ROOM RENTAL TAX AND EXCISE TAX FOR SHORT TERM STAYS
   Amber Martin, Lancaster County Treasurer 
   150 North Queen Street, Suite #122
   P.O. Box 1447, Lancaster, PA 17608-1447
   (717) 299-8222
   
   

4. 1. Legal Name of Owner:
6. 2. Trade/Facility Name:
8. 3. Facility Address (PO Box, Not Acceptable):
10. 4. Email
12. 5. Telephone
14. 6. Billing Address
16. 7. Federal Employee Number (EIN) or Social Security:
18. 8. Applicant Operating as:
    -- Select One --IndividualPartnershipAssociationCorporationOther
20. If other, describe:
22. 9. Please list the name(s), title(s), and telephone number of individual(s) responsible for remitting the county room rental tax:
24. Name
25. Title
26. Number
28. Name
29. Title
30. Number
32. 10. Type of Business:
    -- Select One --HotelMotel InnBed & BreakfastGuest House AirbnbVRBOOther
34. If other describe:
36. 11. Date Opened:
38. Note:

    The Lancaster County Hotel Room Rental Tax of 3.9% does not apply to an establishment that is a Bed and Breakfast Homestead or Inn” as Defined in the Act of May 23, 1945, referred to as the Public Eating and Drinking Place Law. Under that law, the words “Bed & Breakfast Homestead or Inn” shall mean a private residence which contains ten or fewer bedrooms used for providing overnight accommodations to the public and in which breakfast is the only meal served and is included in the charge for the room.

40. Qualification of Bed & Breakfast

    To qualify as a Bed & Breakfast and avoid paying the 3.9% tax you must answer yes on the following three questions. 

42. Do you reside in the guest home providing overnight accommodations?

    1. Yes
    2. No
43. Do you provide breakfast?

    1. Yes
    2. No
44. Does the charge for occupancy of room include breakfast?

    1. Yes
    2. No
46. 12. Number of lodging rooms:
48. 13. Price Range:

    PER DAY

49. 13. Price Range:

    PER WEEK

51. I CERTIFY THAT THE INFORMATION PROVIDED ON THIS REGISTRATION FORM HAS BEEN EXAMINED BY ME, AND IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF TRUE, CORRECT AND COMPLETE.
53. Name
54. Title
56. Signature
57. Date
58. Phone #
60. UPON COMPLETION OF THIS REGISTRATION AND ISSUANCE OF THE CERTIFICATE OF AUTHORIZATION, YOU WILL BE AUTHORIZED BY THE LANCASTER COUNTY TREASURER TO COLLECT AND REMIT THE OCCUPANCY TAX, aka HOTEL ROOM AND HOTEL EXCISE TAX.
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61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit

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