Form Crf-002 - State Tax Registration Application March 2008
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2CRF-002 (Rev. 3/08)
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GEORGIA DEPARTMENT OF REVENUE
REGISTRATION & LICENSING UNIT
P. O. BOX 49512
ATLANTA, GEORGIA 30359-1512
Fax: 404-417-4317 OR 404-417-4318
NEED HELP? CALL (404) 417-4490
State Tax Registration Application
E-MAIL: TSD-sales-tax-lic@dor.ga.gov
Please Read Instructions Before Completing
TSD-withholding-lic@dor.ga.gov
Please Print or Type
IDENTIFICATION SECTION
1
IF YOU HAVE ALREADY BEEN ASSIGNED A STATE TAXPAYER IDENTIFIER (STI), ENTER HERE:
2
Starting a New Business
Adding an Additional Tax Registration
INDICATE THE REASON FOR SUBMITTING THIS APPLICATION:
Change in Alcohol
Change in Ownership Structure
Change in Location Address on Alcohol Accounts *
Licensee *
Adding a
Application for a Master Number (4 or more Locations)
New Location to a Master Sales Tax Account (Master #:
)
3
FOR WHICH OF THE FOLLOWING ARE YOU APPLYING?
Withholding Tax
Non-Resident Distribution
Sales and Use Tax
Amusement License *
Tobacco License*
Alcohol License *
Motor Fuel Distributor License *
e-File/e-Pay Bulk Filer
Applications with an asterisk (*) require an additional application – See instructions for details
(Enter your Full Name as the Legal Business Name if your Business is a Sole Proprietorship)
4
LEGAL BUSINESS NAME
5
TRADE NAME / DBA NAME
6
TYPE OF OWNERSHIP
Sole Proprietorship
County Government
State Agency
Estate
Partnership
Municipality
Federal Agency
Fiduciary
Subchapter S Corp.
Professional Association
LLC
/
/
Corporation
State of Incorporation
Date of Incorporation
7
IF THE BUSINESS LISTED ABOVE HAS A FEDERAL EMPLOYER ID NUMBER (FEIN), ENTER HERE:
8
IF YOUR BUSINESS IS SEASONAL, ENTER THE MONTHS YOUR BUSINESS WILL BE OPEN:
Begin
Thru
9
WHAT IS THE LAST MONTH AND DAY OF YOUR ACCOUNTING YEAR:
Month
Day
10
WHICH ACCOUNTING METHOD WILL YOU USE?
Cash Basis
Accrual Basis
11
IF THIS APPLICATION IS FOR A BUSINESS YOU PURCHASED, PROVIDE THE FOLLOWING INFORMATION REGARDING THE FORMER OWNER;
Legal Business Name
State Tax Identifier:
Georgia Sales Tax Number:
Georgia Withholding Tax Number:
Alcohol License Number:
ADDRESS SECTION
ENTER THE PHYSICAL LOCATION ADDRESS OF YOUR BUSINESS (The location address CANNOT be a P.O. Box):
12
NUMBER AND STREET ADDRESS (including Ste, Apt, Bldg, etc)
CITY
STATE
ZIP CODE
COUNTY
COUNTRY
13
PHONE:
FAX:
E-MAIL:
14
IS THE ABOVE ADDRESS LOCATED WITHIN THE CITY LIMITS?
Yes
No
NOTE:
To have correspondence and reporting forms mailed to a different address, please complete Lines 15 and 16 and indicate the related tax
type(s) for each address. Use Form CRF-003 to list additional mailing addresses.
15
MAILING ADDRESS – IF DIFFERENT FROM THE LOCATION ADDRESS ON LINE 12 ABOVE (The mailing address CAN be a P.O. Box)
(Please identify tax type(s) to be mailed to the address below.)
A
Sales and Use
Withholding
Amusement
Alcohol
Tobacco
Motor Fuel Distributor
B
ADDRESSEE
E-MAIL ADDRESS
(c/o) (If different from or in addition to the Legal Business Name)
C
NUMBER AND STREET, P. O. BOX or RFD NO.
D
CITY
STATE
ZIP CODE
COUNTY
COUNTRY
E
PHONE:
FAX:
16
ADDITIONAL MAILING ADDRESS – (Please identify tax type(s) to be mailed to the address below.)
A
Amusement
Sales and Use
Withholding
Alcohol
Tobacco
Motor Fuel Distributor
B
ADDRESSEE
E-MAIL ADDRESS
(c/o) (If different from or in addition to the Legal Business Name)
C
NUMBER AND STREET, P. O. BOX or RFD NO.
D
CITY
STATE
ZIP CODE
COUNTY
COUNTRY
E
PHONE:
FAX:
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