CITY OF ROSWELL
SPECIAL EVENT LODGERS’ TAX FUNDING -
EVENT/FINANCIAL REPORT
NAME OF EVENT:
DATE(S) OF EVENT:
NAME OF ORGANIZATION SPONSORING EVENT:
NAME OF CONTACT PERSON
MAILING ADDRESS:
CITY / STATE/ ZIP
PHONE:
CELL PHONE:
E-MAIL ADDRESS (optional):
REPORT ON THE OUTCOME OF THE EVENT:
DESCRIBE ADVERTISING USED and IMPACT ON BRINGING VISITORS TO ROSWELL:
WHAT WAS ESTIMATED VISITOR ATTENDANCE?
HOW WAS IT MEASURED?
WHAT WAS THE ESTIMATED HOTEL/MOTEL, LODGING IMPACT?
DO YOU PLAN TO REQUEST LODGERS’ TAX FUNDS NEXT YEAR?
WHAT IS THE ESTIMATED DATE?
IF YOUR EVENT IS SCHEDULED AT THE SAME TIME AS A DIFFERENT EVENT, WOULD YOU BE WILLING TO CHANGE THE DATE?
ADDITIONAL REMARKS TO THE OTB:
SIGNATURE:
DATE:
Provide copies of event surveys collected.
Provide a complete summary of survey results for merchant, restaurant and lodging impact (how many room nights) (see
page 3 of this form).
Event Report is due ninety (90) calendar days following the last day of the event.
Last day of Event___________________________ Received date_______________________ days____________
(Revised Jan. 14, 2016)
SPECIAL EVENT
LODGERS’ TAX FUNDING -
FINANCIAL STATEMENT
FULL EVENT REVENUE:
Admissions
$
Registrations
$
Donations
$
Sale of Items
$
Vendor rental
$
$
$
$
$
$
TOTAL REVENUE
$
FULL EVENT EXPENSES:
*LODGERS’ TAX ELIGIBLE ONLY EXPENSES:
Advertisements **
$
$
Marketing**
$
$
Postage**
$
$
Entertainment
$
$
Food, Beverages, Snacks
$
$
Judges
$
$
Rental Facility
$
$
Rental Equipment
$
$
Sanitation **
$
$
Security **
$
$
Police & Fire **
$
$
$
$
$
$
$
$
$
$
TOTAL EXPENSES
$
$
TOTAL REVENUE: $ TOTAL EXPENSES: $ PROFIT OR LOSS: $
The amount of the expense which is e
ligible for Lodgers’ Tax funding may be less than the Full Event Expense. Lodgers’
Tax Eligible Expenses must equal or exceed the total of a
ll the requests for reimbursement invoice listings.
** Lodgers’ Tax Eligible categories only: Advertisements: Radio, television, newspaper, or magazine advertisements.
Marketing: P
osters, brochures, flyers, postcards, or other marketing materials
Postage: For mailing marketing materials
Online: Website, Facebook, or other internet paid advertising placement
Sanitation, security, police & fire.
Online**
0.00
0.00
0.00
0.00
0.00
SPECIAL EVENT
LODGERS’ TAX FUNDING -
SURVEY SUMMARY
EVENT ATTENDANCE:
TOTAL VISITOR ATTENDANCE:
OUT-OF-TOWN VISITOR ATTENDANCE:
OUT-OF-COUNTRY VISITOR ATTENDANCE:
Total Visitors include all, Out-of-Town are broken out of total but include Out-of-Country
Out-of-Country are broken out of the Out-of-Town
LODGING IMPACT:
HOTEL/MOTEL:
RV PARKS:
BED & BREAKFAST:
TOTAL ROOM NIGHTS
Room nights = # of rooms x # of nights (not people in rooms)
ROSWELL ECONOMIC IMPACT:
RESTAURANTS:
FUEL:
SHOPPING:
If your survey asked these questions please provide results
* Please provide copies of the surveys collected with this form.
0