Form Ut-1000 - Application For Certificate Of Registration
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1Reset Form
UT 1000
Rev. 2/07
Application for
07100100
Certificate of Registration
Account number
Please print.
Federal employer identification no.
Social Security no.
Ohio corporate charter no.
If you are a foreign corporation, give Ohio certificate number
1. Check type of ownership: (10) Sole owner
(20) Partnership
(30) Corporation
(40) Association
(50) LLC
(60) Fiduciary
(70) LLP
(80) LTD
(100) Business trust
2. When did you or will you begin providing taxable sales in the state of Ohio? (mm/dd/yy)
(For the most current NAICS listings,
3. Provide NAICS code and state nature of business activity
visit our Web site at tax.ohio.gov.)
4. Legal name
5. Trade name or DBA
(If partnership, list names)
6. Primary address
(Home/office address of corporation, sole owner or partnership)
City
State
ZIP
(Home/office phone no.)
(Home/office fax no.)
7. Mailing address
(If different from above)
City
State
ZIP
8. List location of all permanent places of business in Ohio, if applicable, and provide vendor's license numbers.
Vendor's license no.
Name
Street
City
State
ZIP
Vendor's license no.
Name
Street
City
State
ZIP
9. Name and address of each agent operating in Ohio.
Name
Street
City
State
ZIP
Name
Street
City
State
ZIP
10. How much sales tax do you expect to collect each month? (06) Less than $200
(01) $200 or greater
11. If this application is for a new registration due to change in ownership, please list the old account number.
12. If you operate as a corporation or partnership, list appropriate names, addresses and social security numbers below.
President/Partner
Name
Street
City
State
ZIP
Social Security no.
Vice-Pres/Partner
Name
Street
City
State
ZIP
Social Security no.
Secy/Treas/Partner
Name
Street
City
State
ZIP
Social Security no.
I hereby declare the above to be true and correct to the best of my knowledge and belief.
Date
Signature of owner or officer of company
Mail to: Ohio Department of Taxation, Registration Unit, P.O. Box 182215, Columbus, OH 43218-2215.
Phone (888) 405-4089. No registration fee required.
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