Alatax New Account Registration Form - 2002

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ALATAX NEW ACCOUNT REGISTRATION FORM
PLEASE FAX THIS COMPLETED FORM TO (205) 324-1538
1 - FEIN # ___________________________ OR Social Security # _________________________________
2 -
Corporation
Sole Proprietorship
Partnership
Professional Association
Other
3 - Physical Location of Business:
City:___________________ County:_______________ State:___________
4 - Indicate the Type of Tax and Rate You Will be Filing:
Sales Tax
Seller’s Use Tax
Consumer Use Tax
Other, please specify _____________________
General Rate
Automotive Rate
Mfg. Machine Rate
Agricultural Rate
Amusement Rate
Vending
5 – Indicate the Jurisdictions you will be filing tax in: (Please see tax rate listing for a current list of all Jurisdictions
Administered by AlaTax,
Inc.)___________________________________________________________________________________________
____
______________________________________________________________________________________________
____
6 – Complete the following information: (All below information is required!)
Taxpayer’s Name:
_________________________________ Contact Person: __________________________
DBA Name:
_________________________________ Title:
___________________________
Mailing Address:
_________________________________ E-Mail Address:_________________________
_________________________________ Street Address: _________________________
City/State/Zip:
_________________________________ City/State/Zip: _________________________
Phone: ________________________________
Fax: _________________________________
Begin Date:
_________________________________ SIC Code ____________________________
______________________________
__________________________
_____________________
Signature
Title
Date
Account Registration - ALATAX, Inc. 2002

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