Form Bb-1 - Basic Business Application - State Of Hawaii - 1998

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FORM BB-1
This Space For Office Use Only
(1998)
Identification No.
STATE OF HAWAII
___ ___ ___ ___ ___ ___ ___ ___
BASIC BUSINESS
U.I. Registration Number
APPLICATION
TYPE OR PRINT LEGIBLY
1.
Type of application
General Excise (G.E.)
Transient Accommodations
Use Tax Only
Cigarette and Tobacco
Employer’s Withholding
G.E. One Time Event
Liquid Fuel Distributor
Rental Motor Vehicle & Tour Vehicle
Unemployment Insurance
Seller’s Collection
Liquor
Liquid Fuel Retail Dealer
2.
Taxpayer’s/Employer’s Name
3. Doing business as (DBA) name
4.
Mailing address
C/O
Street address or P.O. Box
City
State
Zip Code + 4
5.
Physical location of business
Street address
City
State
Zip Code + 4
6.
If no physical business location in Hawaii, provide the name, address, and telephone number of the individual performing services in Hawaii
7.
Type of ownership
Sole proprietorship
Corporation
State Agency
Other (Explain)
Partnership
Federal Agency
City Agency
8.
Phone Number
Business
Fax
Residential
(
)
(
)
(
)
9.
Taxpayer’s Social Security Number
10. Spouse’s Social Security Number
11. Federal Employer I.D. Number
12. List of owners, partners, principal corporate officers (Attach a separate sheet of paper if more space is required.)
Name
Business/Residential
Social Security Number
Title
Residential Address
Phone Number
(Last, First, Middle Initial)
(
)
(
)
(
)
13. a) Did you acquire an existing business?
Yes
No b) Was
all or
part of the business acquired? c) When was it acquired?
MO/DAY/YR
d) Previous owner’s/business’ name, dba, address, G.E. I.D. No., and U.I. Account No.
14. TYPE OF BUSINESS ACTIVITIES: (Circle all that apply. See Instructions for description of each business activity)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Describe fully the type of business activities you are engaged in, concentrating on your principal activity and the product/service. Include the percentage based
on gross receipts if you are engaged in more than one type of activity. See Instructions.
15. Number of establishments or branches in Hawaii operated by this employing unit
16. Date business began in Hawaii
17. Date employment began in Hawaii
18. No. of employees on date employment began
/
/
/
/
19. If no employees, when do you anticipate hiring employees?
20. Date first wages paid in Hawaii
Continue on back of this page.
/
/
CERTIFICATION: The above statements are hereby certified to be correct to the best of knowledge and belief of the undersigned who is duly authorized to
sign this application.
Signature of Owner, Partner or Member, Officer or Agent
Print Name
Title
Date
DO NOT WRITE IN THIS SPACE
This Space for Date Received Stamp
Type
Number
Date Issued
Effective FYE
Liquor Tax Permit
Cigarette Tax and Tobacco Tax License
Liquid Fuel Distributor’s License
Liquid Fuel Retail Dealer’s Permit
FORM BB-1
02

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