Form Tc-69 - Utah State Business And Tax Registration Page 8
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8Section 14 – Authorized Signatures
Required by all applicants.
I understand the Tax Commission will review all officers/owners listed in Section 2j (page 3) for previous, unpaid tax debt and I may
have to resolve tax issues or post a bond.
I understand any person (including employees, corporate directors, corporate officers, etc.) who has or will have the authority to
direct accounting processes or who is required to collect, account for and pay any taxes and fails to do so will be liable for a penalty
equal to the total amount of tax not collected, not accounted for or not paid (Utah Code §59-1-302).
I understand I am required to notify the Tax Commission if I add or close a business location; or change the name, organizational
structure, officer status or address of the business.
I also understand my signature confirms I have reviewed this section with all those named on this form.
Signature Requirements (for organizational structure checked on line 2a):
• Individual/Sole Proprietor............................................ Signature must match SSN provided in Section 2 (2e)
(for example, a husband or wife may not sign on behalf of each other).
• All Partnerships ........................................................... One general partner must sign.
• Corporation / S Corporation ........................................ An officer of the corporation authorized to sign on behalf of the corporation must sign.
• Trust............................................................................. The grantor or a trustee must sign.
• Limited Liability Company / Single Member LLC......... A member must sign.
• Government................................................................. A government official must sign.
14a. Sole Proprietors Only
You must provide the following information if you are a sole proprietor applying for the tax license(s) shown in Section 1 of
this application. Under state and federal law we cannot issue a license to any person who does not provide this information.
If you are a sole proprietor who is not a U.S. citizen, you must file this application IN PERSON at a Tax Commission office.
Check one (providing false information subjects the signer to penalties of perjury):
I am a U.S. citizen and have provided my Social Security Number in Section 2 (2e).
I qualify under 8 U.S.C. 1641 and I am present in the U.S. lawfully.
I-94 Number*: ___________________________
Alien Registration Number*: ___________________________
Employment Authorization Card Number*: ___________________________
*The I-94 (arrival/departure) number and the Alien Registration Number are
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issued by the U.S. Citizenship and Immigration Service.
Under penalty of perjury, I declare that I am a U.S. citizen OR that I qualify under 8 U.S.C. 1641 and am present in the United
States lawfully.
Sign here after the form is printed.
Sole Proprietors Sign Here: __________________________________________
Title: __________________
Print Name: __________________________________________
Date: __________________
14b. All Applicants
Under penalty of perjury, I declare that, to the best of my knowledge, the information on this application is true, correct and
complete.
Sign here after the form is printed.
ALL APPLICANTS Sign Here: __________________________________________
Title: __________________
Print Name: __________________________________________
Date: __________________
Reporting and Payment Guidelines
If you do not file a return or pay taxes due, you will be sent a tax
Always file tax returns by the due date and pay taxes in full. You must file a
delinquency notice and/or contacted. If you disagree with an action taken by
return, even if no taxes are due. Enter zero tax, sign and date your return,
the Tax Commission, you may file an appeal within 30 days of receiving the
and file by the due date.
notice. See Pub 2, Utah Taxpayer Bill of Rights.
You must file and pay timely, even if you do not receive a preprinted form.
For questions about EFT payments, see form TC-86 for sales and use tax, or
Get forms online at tax.utah.gov/forms, at all Tax Commission locations, or
call 801-297-3817. For employer withholding, see Pub 43, or call 801-297-7626.
by calling the automated forms line at 801-297-6700.
IMPORTANT: To protect your privacy, use the "Clear form" button when you are finished.
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