Municipal Income Tax Business Registration Form printable pdf download

Municipal Income Tax Business Registration Form

INCOME TAX DEPARTMENT

VILLAGE OF BOLIVAR

BETH WATSON – TAX ADMINISTRATOR

109 CANAL STREET NE

P.O. BOX 204

(330) 874-3717

BOLIVAR, OH 44612

(330) 874-3713 FAX

MUNICIPAL INCOME TAX BUSINESS REGISTRATION FORM

BUSINESS NAME: _____________________________________________FEDERAL ID #______________________

ADDRESS: ____________________________________________________________________________________

PHONE: ____________________________ START DATE WITHIN VILLAGE LIMITS: ________________________

TYPE OF FIRM:

CORPORATION

SOLE PROPRIETORSHIP

PARTNERSHIP

OTHER

►CORPORATION:

PRESIDENT’S NAME: _________________________________________________SS#____________________

ADDRESS/PHONE: __________________________________________________________________________

___________________________________________________________________________________________

VICE PRESIDENT’S NAME: ____________________________________________SS#_____________________

ADDRESS/PHONE: ___________________________________________________________________________

____________________________________________________________________________________________

►PARTNERSHIP:

IS PARTNERSHIP FILING AS AN ENTITY? (circle one)

YES

IF NO, COMPLETE THE FOLLOWING:

PARTNER’S NAME: ___________________________________________________SS#____________________

ADDRESS/PHONE: ___________________________________________________________________________

____________________________________________________________________________________________

PARTNER’S NAME: ___________________________________________________SS#_____________________

ADDRESS/PHONE: ____________________________________________________________________________

_____________________________________________________________________________________________

(LIST ADDITIONAL ON BACK OF FORM)

►SOLE PROPRIETORSHIP:

NAME OF PROPRIETOR: ______________________________________________SS #_____________________

ADDRESS/PHONE: ____________________________________________________________________________

_____________________________________________________________________________________________

PLEASE COMPLETE OTHER SIDE

Municipal Income Tax Business Registration Form