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City Sales Tax e-Form

Type of Organization:
Taxpayer Name:
Business Name:
Address of Principal Place of Business:
Telephone:
E-mail:
What products and/or services do you provide?

Owner/Partner/Corp. Officer:

Owner/Partner/Corp. Officer:

Title

Title

Social Security Number

Social Security Number

Date of Birth

Date of Birth

Address

Address

Telephone

Telephone
If you acquired the business in whole or in part, complete the following.
Prior Taxpayer Name:
Date of Acquisition:
Prayer Taxpayer UI Tax Number:
Address:
Filing Frequency:
Effective Date of Business:
State Sales Tax Number: