HOT-AA www.hctax.net Rev. 10/16 v 1
This form is for use by a hotel owner in designating a lessee or other person to act as the owner’s agent for hotel occupancy tax
payments and filings. This designation will not take effect until filed with the Harris County Tax Assessor-Collector’s Office. Once
effective, this designation will be in effect until the earlier of (1) the date of a written revocation filed with the Tax Assessor-
Collector’s Office by the owner or the owner’s designated agent, or (2) the expiration date, if any, designated below.
Name Phone Number (including area code)
Address City, State, Zip Code
Name Phone Number (including area code)
Address City, State, Zip Code
Date Agent’s Authority Ends:
Authorized Individual’s Signature* Date
Authorized Individual’s Printed Name
The individual signing this for is (check one):
the hotel owner
a property manager authorized to designate agents for the owner
another person authorized to act on the owner’s behalf other than the person being designated as agent.
* This form must be signed by the hotel owner, a property manager authorized to designate agents for the owner, or other person
authorized to act on the owner’s behalf other than the person being designated as agent. If you are a person other than the hotel
owner, the Tax Assessor-Collector may request a copy of the document(s) authorizing you to designate agents or act on behalf of the
hotel owner.
If you have additional hotels for which authority is granted, attach additional sheets providing the TP# and Hotel Name
for each property. Identify the number of additional sheets attached: .................................................................................
If you make a false statement on this form, you could be found guilty of a Class A misdemeanor or a state jail felony under section 37.10, Penal Code.
Step 1: Owner’s Name and Address
Step 2: Identify the Hotel Property. Identify all property for which you are granting the agent authority by completing the TP#’s
and Hotel Name for each in the table below. The Tax Assessor-Collector may, if necessary to identify the property, request
additional information. Additionally, in lieu of listing property below, you may attach a list of all property to which this
appointment applies, denoting the total number of additional pages attached in the lower right-hand corner below.
Step 3: Identify the Agent
Step 4: Date the Agent’s Authority Ends. This designation remains in effect until the date indicated below or until a written
revocation is filed with the Tax Assessor-Collector’s Office by the hotel owner or the owner’s representative. A designation may
be made to expire according to its own terms but is still subject to prior revocation by the hotel owner or owner’s
representative. By designating an agent on this form, previous designations of other agents in connection with the hotel
property shown on the form are revoked.
for Online Payments and Filings
