FORM L Page 1of 2 PRESS CTRL-P TO PRINT BACK FORM L.T. III (See clause (b) of the sub-rule(1) of rule 5 and sub-rule (1) of rule 6 of the Himachal Pradesh Tax on Luxuries (in Hotels and Lodging Houses) Rules, 1979) DAILY ACCOUNT OF OCCUPANCY OF ROOMS AND COLLECTION OF TAX (N.B.- Separate entry should be made in respect of each person) Name of Hotel/Lodging House......... Sl. Name of the Age Nationality Name or No. Rates of charges for accomm- No. guest of the room odation for residence per day occupied per guest. (1) (2) (3) (4) (5) (6) Arrival date Departure date Period of stay Total amount of Time Time of each guest charges for acco- mmodation for residence 7. (8) (9)(10) Charges paid by guest in foreign No. of guest who occupied the room Currency or Indian currency or accommodation in hotel (11) (12) (a) No. and date of bill Amount of Luxury Remarks http://hptax.nic.in/ltf3.htm 4/11/08 FORM L Page 2of 2 ---------------------------- tax collected (b) No. and date of cash memo (13) (14) (15) Dated...... Signature....... Name.......... Designation...... I, the above named Shri......residing at..... Do hereby solemnly affirm and say that the contents of the above return are true according to the best of my information and belief. Place: Signature of Proprietor. Date : http://hptax.nic.in/ltf3.htm 4/11/08
