Business Registration And Employer'S Withholding Registration Form - City Of Ionia Income Tax Divison
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1CITY OF IONIA INCOME TAX DIVISON
PO BOX 512 114 KIDD STREET IONIA MI 48846
616-527-5729 or 616-527-TAXS
BUSINESS REGISTRATION AND EMPLOYER'S WITHHOLDING REGISTRATION
TRADE NAME
MAILING ADDRESS
FEDERAL ID #
OWNERS NAME
IONIA ADDRESS
TYPE OF ORGANIZATION
___INDIVIDUAL OWNER ____PARTNERSHIP _____CORPORATION ____NONPROFIT ____OTHER
(ATTACH EXPLANATION)
PHONE NUMBER
LOCAL PHONE NUMBER
NUMBER OF EMPLOYEES
DATE BUSINESS AQUIRED
DATE FIRST PAID WAGES SUBJECT TO
WITHHOLDING IN IONIA
WAS THIS BUSINESS PREVIOUSLY OPERATED BY ANOTHER EMPLOYER?
GIVE NAME
ACCOUNTING PERIOD ___CALENDAR YEAR
___FISCAL YEAR ENDING________
PLEASE CHECK ONE:
____RESIDENT BUSINESS-- LOCATED INSIDE IONIA CITY LIMITS AND/OR DOING BUSINESS OR PERFORMING
SERVICES INSIDE IONIA CITY LIMITS. A RESIDENT BUSINESS IS REQUIRED BY THE UNIFORM CITY INCOME TAX
ORDINANCE TO WITHHOLD AND REMIT CITY INCOME TAX ON RESIDENT AND NONRESIDENT EMPLOYEES AND
FILE A W-3 WITH W-2'S BY FEBRUARY 28 OF EACH TAX YEAR. BUSINESS IS ALSO RESPONSIBLE FOR FILING A
RETURN WITH THE CITY BASED ON INCOME EARNED INSIDE IONIA CITY LIMITS.
___NONRESIDENT BUSINESS-- A BUSINESS WITHHOLDING IONIA CITY INCOME TAX FOR RESIDENTS OF THE CITY
OF IONIA WHO WORK AT A BUSINESS LOCATED OUTSIDE CITY LIMITS. THIS BUSINESS IS REQUESTING TO BE
ALLOWED TO WITHHOLD FROM CITY OF IONIA RESIDENTS WORKING AT THIS BUSINESS AND AGREE TO REMIT
QUARTERLY WITHHOLDING PAYMENTS AND YEAR END W-3 WITH W-2S AS IS REQUIRED BY THE UNIFORM CITY
INCOME TAX ORDINANCE.
__OTHER - PROVIDING SERVICES OR CONDUCTING BUSINESS INSIDE CITY LIMITS ON A SHORT TERM BASIS –
EXAMPLE CONTRACTORS, PEDDLERS, FAIR VENDERS, ANTIQUE DEALERS ETC. RESPONSIBLE FOR TAX ON
INCOME EARNED IN IONIA AND POSSIBLE WITHHOLDINGS ON EMPLOYEES. MUST AT LEAST REPORT WAGES
EARNED OF EMPLOYEES WORKING INSIDE CITY LIMITS. MUST WITHHOLD PER UNIFORM CITY INCOME TAX
ORDINANCE.
By signing this form, I declare that I understand all of my obligations to the City of Ionia for income tax and that I will abide by the
requirements of the Uniform City Income Tax Ordinance and the City of Ionia Income Tax Department rules and regulations. I also
declare that the information provided here is to the best of my knowledge true, complete and correct.
________________________________________
______________________
________________________
SIGNATURE
TITLE
DATE
PHONE NUMBER
CITY OF IONIA INCOME TAX DIVISION
REQUIRED: EMPLOYERS FEDERAL
PO BOX 512 114 N KIDD ST IONIA MI 48846
IDENTIFICATION NUMBER _______________
616-527-TAXS
__We use the following payroll company to remit our withholding tax
Name of payroll company ___________________________-
Address __________________________________________
CONTACT PERSON _______________________________
PHONE NUMBER _________________________________
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