Form Crf-002 - State Tax Registration Application

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CRF-002 (Rev. 12/10)
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 1 (877) 423-6711
E-MAIL:
ST-License@dor.ga.gov
State Tax Registration Application
TSD-withholding-lic@dor.ga.gov
(Please Read Instructions Before Completing, Please Print or Type)
SECTION 1 - Reason for the Registration
(Check all applicable boxes to indicate the reason(s) for this registration.) Bolded questions with (*) represent required fields. If the bolded fields are not
completed, the applicant will receive a letter requesting the completion of this form. NOTE: If your business is 100% service or your business will not
sell any tangible personal property you will not need a sales and use tax number.
6. Did your business:
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1.New Registration
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A. Acquire all or part of another business?
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2. Additional tax registration
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B. Result from a change in legal structure? (e.g. from individual to partnership,
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3. Application for a Master Number (4 or more locations)
partnership to corporation, corporation to Limited Liability Company)
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4. Information Update
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C. Undergo a merger, consolidation, dissolution, or another restructuring?
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5. Additional Location - Master Sales Account Only
If yes to any of the above, list previous State Tax Identification,
enter here:___________________________
7. If you already have a State Tax Identification Number, enter here: _____________________________________
8.* For which tax registration are you applying? Check all that apply. Registrations with asterisk (**) require an additional application; see instructions for
details.
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Sales and Use
Alcohol License**
Limousine Alcohol License**
Motor Fuel License**
Non-Resident Distribution
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Withholding Tax
Tobacco License**
Lottery Retailer**
Amusement License**
Electronic Bulk Filer
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Motor Carrier/IFTA
Contractor
SECTION 2 - Business Information
1.* Date of First Operation (mm/dd/yyyy)
2. Business Fiscal Year End
3.* Business Legal Name
4. Federal Employer Identification Number (FEIN)
5. Business Trade Name (DBA)
6.* Business Telephone Number
7.* Business Street Address (can not be a PO BOX)
City / Town
County
State
Zip
NOTE: To have correspondence and reporting forms mailed
to a different address, please complete line 8 and indicate the related tax type(s)
for each address. Use Form CRF-003 to list additional
addresses.
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Sales and Use
Withholding
Amusement
Alcohol
Tobacco
Motor Fuel Distributor
8.*Business Mailing Address (if different from above)
City / Town
County
State
Zip
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Alcohol
Tobacco
Motor Fuel Distributor
Sales and Use
Withholding
Amusement
City / Town
County
State
Zip
8.*Business Mailing Address (if different from above)
9. Which accounting method will your business use?
10.* If your business is seasonal, list months of operation. (mm - mm)
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Accrual
Cash
11. Email:__________________________________________ 12. Fax: ________________________________________
SECTION 3 - Business Structure
Check the type of business structure your business represents. (You must select one of the following.)
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Sole Proprietorship
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Partnership
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Corporation
/
State of Incorporation
Date of Incorporation
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Sub-Chapter S Corporation
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Limited Liability Corporation / Single
Multiple
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Limited Liability Partnership
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Fiduciary
Professional Association
Estate
Federal Agency
State Agency
County Government
Municipal
Government
CRF - 002 - Registration Application 1

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