Your Business Registration Application Form Page 2
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5Your Business Registration Application
For multiple locations, indicate the number of copies attached:
FEIN/SSN
Business Name
Withholding Tax
6. Do you now or do you intend to withhold Oklahoma Income Tax from employees?
Yes
No
(a) If “yes” on item 6, do you expect to withhold more than $500 per quarter?
Yes
No
(b) If “yes” on item 6, date you will begin/began withholding Oklahoma Income Tax:
/
/
(month/day/year)
7. (a) Date you will begin/began withholding for nonresident royalty interest?
/
/
not applicable
(b) Date you will begin/began withholding for pass-through members?
/
/
not applicable
(month/day/year)
(if different
8. What FEIN will you use to report withholding tax?
than item 2)
OFFICE USE
Physical Location, Classification and Information
ONLY
9. Trade Name of Business (DBA)
Status:
10. Physical Location of Business:
FR
WH
Street and Number or Directions (Do not use post office box or rural route number)
Sales Tax
City, State, Zip and County
11. Is this business located inside the city limits of the city listed above?
MSEP
Yes
No
12. Are all sales from this location made in the city & county listed above?
Approved
Yes
No
13. Business Phone (
)
Business Fax (
)
Denied
14. Principal type of business:
Retail
Wholesale
Service
Manufacturing
V
Copper/Aluminum Salvage
Other
C
15. List your principal products or services for this location:
Use Tax
COPO
16. Please check the box(es) if you sell:
3.2 Beer
Cig./Tobacco
Mixed Drinks
Motor Fuel
Tires
SIC Code
17. Is this a home based business?
Yes
No
18. Is this a new business without a previous owner?
Yes
No
NAICS Code
19. Did you buy this business from the prior owner?
Yes
No
Form Type:
19a. If you answered yes, did you pay sales/use tax on tangible items purchased
Short
for use (fixtures/equipment, not resale inventory)?
Yes
No
Long
Electronic
20. If you answered yes to Item 19, please mark the types of item you purchased from
the previous owner and give name and address of the previous owner:
M
Fixtures/Equipment
Inventory
Other
X
Previous Owner’s name and address:
C
Mixed Beverage
Application continued on page C...
B
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