Form Rv-F1300501 - Application For Registration Page 2

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D. Do you lease tangible personal property in one location for use in another?
Yes
E. Do you lease space in a business location to another company?
Yes
F. Do you sell at retail? _________________ Wholesale? _________________ Both? ___________________
Yes
No
G. If you are a contractor, do you perform contracts in the city or county of your business?
H. If a contractor, do you install everything you sell?
Yes
No
Business Phone Number: ______________________________ E-mail address: __________________________
Business Fax Number: ___________________ Business Contact Person: _______________________________
EDI/EFT
17.
NO
DO YOU CURRENTLY REMIT PAYMENT BY EFT?
YES
DO YOU CURRENTLY FILE YOUR RETURN BY EDI?
YES
NO
WOULD YOU LIKE TO RECEIVE INFORMATION ABOUT THE FOLLOWING:
EFT
EDI
18.
IDENTIFY OWNERS, OFFICERS, OR PARTNERS (ATTACH ADDITIONAL NAMES AND SOCIAL SECURITY NUMBERS ON SEPARATE SHEET).
SOCIAL SECURITY #
(1) NAME
HOME TELEPHONE #
HOME ADDRESS (DO NOT USE P.O. BOX #)
CITY
STATE
ZIP CODE
(2) NAME
SOCIAL SECURITY #
HOME TELEPHONE #
CITY
STATE
ZIP CODE
HOME ADDRESS (DO NOT USE P.O. BOX #)
(3) NAME
SOCIAL SECURITY #
HOME TELEPHONE #
HOME ADDRESS (DO NOT USE P.O. BOX #)
CITY
STATE
ZIP CODE
PREVIOUS OWNER'S TELEPHONE #
PREVIOUS BUSINESS NAME
STILL IN BUSINESS?
(
)
YES
NO
PREVIOUS OWNER'S NAME AND ADDRESS
19.
IF YOU ARE AN OUT-OF-STATE BUSINESS WHO WILL BE DOING BUSINESS IN TENNESSEE, PLEASE ANSWER THE FOLLOWING QUESTION.
DO YOU HAVE A LOCATION OR OFFICE IN TENNESSEE?
NO
IF YES, NAME LOCATION:
YES
20.
THE STATEMENTS MADE ON THIS APPLICATION ARE TRUE TO THE
FOR DEPARTMENT USE ONLY
BEST OF MY KNOWLEDGE AND BELIEF. (THIS APPLICATION MUST
BE SIGNED BY THE INDIVIDUAL OWNER, A PARTNER, OR AN OFFICER
OF THE CORPORATION) LISTED IN ITEM 18.)
SIGN
HERE:
OWNER, PARTNER, OR OFFICER (DO NOT PRINT OR USE STAMP)
For additional information, contact the Taxpayer and Vehicle Services Division in one of our Department of Revenue Offices:
Knoxville
Chattanooga
Jackson
Johnson City
Memphis
Nashville
(865) 594-6100
(901) 213-1400
(615) 253-0600
(423) 634-6266
(731) 423-5747
(423) 854-5321
Room 606
3150 Appling Road
3rd Floor
Suite 350
Suite 340
204 High Point Drive
State Office Building
Andrew Jackson Building
State Office Building
Lowell Thomas Building
PO Box 2365
Bartlett, TN 38133
531 Henley Street
540 McCallie Avenue
225 Martin Luther King Blvd.
Johnson City, TN 37605-2365
500 Deaderick Street
Knoxville, TN 37901
Chattanooga, TN 37402
Jackson, TN 38301
Nashville, TN 37242
Tennessee residents can also call our statewide toll free number at 1-800-342-1003. Out-of-state callers must dial (615) 253-0600.
INTERNET (1-07)

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