Application For Sales And/or Use Tax License Form - Colorado Sales Tax Division Page 2

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PLEASE ANSWER ALL QUESTIONS COMPLETELY — FAILURE TO DO SO MAY RESULT IN A DELAY IN ISSUING YOUR LICENSE.
APPLICATION FOR SALES AND/OR USE TAX LICENSE
CITY OF COLORADO SPRINGS
SALES TAX DIVISION
COST OF LICENSE FOR
P.O. BOX 1575, MC 225 COLORADO SPRINGS, CO 80901-1575
RETAIL BUSINESS IS $15.00.
TEL 719-385-5903
NO FEE FOR
USE TAX ONLY ACCOUNTS
A SEPARATE LICENSE IS REQUIRED FOR EACH PLACE OF BUSINESS
1. Trade name of business __________________________________________________________Phone ______________________
2. Corporate name or partnership name, if any ____________________________________________________________________
(As registered with the Secretary of State)
3. Business Address ______________________________________________________________________________________________________________________
No. and Street
City
State
Zip Code
4. Mailing Address _______________________________________________________________________________________________________________________
P .O. Box or No. and Street
City
State
Zip Code
5. What do you sell? _______________________________________________________________________
 Retail
 Wholesale
 Use Tax Only
6. Date tax liability first incurred in Colorado Springs ___________________________________________________________________________________________
a. If purchased, former owner, business name and license number _____________________________________________________________________________
b. If incorporated, former owner, business name and license number ___________________________________________________________________________
7. Type of ownership:
 Individual
 Partnership
 Corporation
 Club or Association
 Other ___________________________________
Enter Federal Tax ID Number _______________________________________
8. Names, addresses, phone and Social Security numbers of individual, partners and/or corporate officers (with titles) of business for this application:
Title
Name
Resident Address
City and State
Zip Code
Phone
Social Security #
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
9. a) Names, addresses or other business locations inside Colorado Springs and Sales Tax License numbers: (if additional
space is needed, attach separate sheet.)
DO NOT WRITE IN
Name of Business
Business Address
City Sales Tax Number
THIS COLUMN
_____________________________________________________________________________________________________
______U/T
_____________________________________________________________________________________________________
______Jan
b) If more than one location, do you prefer to file tax returns for
 each location or
 a consolidated return.
______Feb
10. Local Representative or Manager information:
______Mar
______Apr
Name __________________________________________________________ Title ___________________________________
______May
Residence Address ___________________________________________Zip Code ____________ Phone ___________________
______Jun
11. Select frequency of filing returns:
______Jul
 Monthly
 Quarterly (allowed only if City Sales/Use Tax liability is less than $200 per month)
______Aug
______Sep
I declare, under penalty of perjury, that this application has been examined by me, that the statements made herein are
made in good faith and, to the best of my knowledge and belief, are true, correct and complete.
______Oct
______Nov
Signed __________________________________________________________ Title ___________________________________
(Must be signed by Individual Owner, Partner or Officer)
______Dec
Residence Address _______________________________________________________________________________________
Filing ____________
City ____________________________________________________________ State ___________ Zip Code _______________
Industry __________
Email ___________________________________________________________ Date ________________________ , _________
OS 1473-10

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