DOOR COUNTY TOURISM ZONE COMMISSION                         (back)

DUE BY MAY 15, 2007 Year: _________

PO BOX 55 , Sister Bay, WI  54234   (920) 854-6200

Check Applicable Box

New Application

□

Renewal Application

□

Email: DCTourismZoneCommission@gmail.com

PLEASE PRINT WITH BLACK INK

Business Information

Business Physical Location

Business Name

Address or Fire Number (No P.O. numbers)

Mailing Address

Municipality

State

Zip

Address 2

Phone Number

City

State

Zip

Type of Lodging

□ Hotel/Motel                                  □ Resort                       □Inn                                                                                                  □ Condominium Property              □ B & B                        □ Cottage / Cabin

□ House                                          □ Other

Number of units:

Owner or Owner’s Agent

Individual responsible for collecting and remitting the room tax. (see below)

Name

Mailing Address (if the same as business leave blank)

Address 2

City

State

Zip

Phone Number Cell phone:

E-mail address: Fax number:

Operating Period & Number of units available

Indicate the total number of units available for rent during each month of the year.

□ Open year round

Jan

Feb

Mar

Apr

May

June

July

Aug

Sept

Oct

Nov

Dec

Certificate

I, the undersigned, hereby apply for a Lodging Permit, certify that all the information both above and attached is true, and correct to the best of my knowledge.

___________________________________________ _______________________________________

Signature Date Daytime Phone Number

___________________________________________ ________________________________________

Print Name E-mail Address

Approvals

Date Received

Date Issued

Approved By

Permit Number

In cases where the individual responsible for collecting and remitting the room tax changes, such as a change in ownership or a change in the owner’s agent, the issuance of a new permit is required.

LODGING PERMIT APPLICATION