Tax Exempt Form

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The State of Colorado and the Town of Breckenridge require that an affidavit must be completed by any organization requesting exemption from sales and accommodations tax at local lodges or hotels. If an organization does not complete this form, exemption will not be granted.
Please be aware a 5.5% resort fee remains applicable to all reservations.
Name and Address of Organization: ____________________________________________
Event/Meeting/Conference Name: _______________________________________________
Name of Hotel Guest/s:   ____________________________________________
Reservation Number/s:   ____________________________________________
Dates of Stay:    __________________________________________________
Tax Exempt:    Yes______   No ______
State of     ____________________________________________
Exemption Number:   ____________________________________________
Category:    _____ Charitable
                   _____ Governmental
                   _____ Not-For-Profit School
                   _____ Religious

Please circle your answers to the following questions and return the affidavit to Beaver Run Resort.
NOTE: All questions must be answered “YES” for the purchase to qualify as tax exempt.

Yes/No Is the organization a governmental entity, a not-for-profit school, a qualified religious organization, or a qualified charitable organization?
Yes/No Is this purchase billed directly to the organization and paid for directly by the organization from funds of the organization?
Yes/No Is the purchase paid for out of the budget of the organization and not reimbursed back to the organization by any individuals who attend this meeting or event?
Yes/No Is the purchase being made for use by the organization in its exempt capacity?
The undersigned attests that the answers to the above statements are true and that he/she has the capacity, as a representative of the organization, to complete this document.

Name: _________________________________ Title: ________________________________
Signature: ___________________________ Date: ________________________________

Folio number:

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