Form Crf-002 - State Tax Registration Application
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2CRF-002
(rev. 09/01)
GEORGIA DEPARTMENT OF REVENUE
REGISTRATION UNIT
P.O. BOX 49512
ATLANTA, GA 30359-1512
STATE TAX REGISTRATION APPLICATION
(PLEASE PRINT OR TYPE)
(Please Read Instructions Before Completing)
IDENTIFICATION SECTION
1.
IF YOU HAVE A STATE TAXPAYER IDENTIFIER (STI), ENTER HERE:
2.
REASON FOR APPLICATION:
New Business
Additional Tax Registration
Application for Master Sales Tax Number
Change in Ownership Structure
Change in Alcohol Licensee
Divided Store (Alcohol Only- Separate Applications required.)
Change in Location Address
New Location for a Master Sales Tax Account
Master Sales Tax Number: ___________________
3.
FOR WHICH OF THE FOLLOWING ARE YOU APPLYING?
IFTA Registration*
Sales Tax
Use Tax Only
Tobacco License
Motor Fuel Distributor*
Withholding Tax
Motor Carrier Permit
Motor Fuel Tanker Truck Permit*
Alcohol License*
Amusement Machine*
Non-Resd. Distribution
Applications with an asterisk (*) require an additional registration. See instructions for details.
4. LEGAL BUSINESS NAME:
(If your business is a Sole Proprietorship-
Your name is the 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 – Indicate State of Inc._______________
Indicate the Date of Inc.
______________________________
7.
IF THE BUSINESS LISTED ABOVE HAS A “Federal Employer ID” NUMBER, ENTER HERE:
8.
IF SEASONAL BUSINESS, STATE MONTHS BUSINESS WILL BE OPEN:
Begin
Thru
9.
WHAT ACCOUNTING METHOD WILL YOU USE:
Cash Basis
Accrual Basis
10. IF THIS APPLICATION IS FOR A BUSINESS YOU PURCHASED, PROVIDE THE FOLLOWING INFORMATION REGARDING THE FORMER
OWNER, IF KNOWN:
Legal Business Name
State Identification Number
Georgia Sales Tax Number
Georgia Withholding Tax Number
Purchase Price of Business $
ADDRESS SECTION
11.
PHYSICAL LOCATION ADDRESS, NUMBER AND STREET SUITE/APARTMENT NO.: (You CANNOT use a P.O. Box)
Address
City
State
ZIP Code
County
Country
Phone Number
IF A POST OFFICE BOX IS USED, IT WILL DELAY THE PROCESSING OF THIS APPLICATION.
12.
IS THE ABOVE ADDRESS LOCATED WITHIN THE CITY LIMITS?
YES
NO
Note: To have correspondence and reporting forms sent to separate addresses, please complete Line 13 and 14 and indicate the
related tax type(s) for each. To list additional mailing addresses use Form CRF-003.
13. MAILING ADDRESS – If Different from the Location Address on Line 11 above, please identify tax type(s) to be mailed to the address below.
Sales and Use Tax
Withholding
Alcohol/Amusement
Tobacco
Motor Carrier/Tanker Truck
Motor Fuel Distributor
A
B ADDRESSEE (c/o) (If different from or in addition to the Legal Business Name)
C NUMBER AND STREET, P.O. BOX or RFD NO.
CITY
STATE
ZIP
D COUNTY
COUNTRY
PHONE
14. ADDITIONAL MAILING ADDRESS – (Please identify tax type(s) to be mailed to the address below)
Sales and Use Tax
Withholding
Alcohol/Amusement
Tobacco
Motor Carrier/Tanker Truck
Motor Fuel Distributor
A
B ADDRESSEE (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
COUNTY
COUNTRY
PHONE
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