Form 126 - Registration Change Request Page 2
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I WOULD LIKE TO CHANGE FROM A TRANSIENT EMPLOYER TO A REGULAR EMPLOYER. (MUST HAVE FILED 24 CONSECUTIVE MONTHS IN MISSOURI.)
8.
M
M
D
D
9. CHANGE THE CORPORATION TAXABLE YEAR END TO:
10. CHANGE MAILING ADDRESS FOR:
ALL TAX TYPES
SALES/USE TAX
EMPLOYER WITHHOLDING TAX
CORPORATE INCOME / FRANCHISE TAX
IN CARE OF (NOT REQUIRED)
STREET, ROUTE OR PO BOX
CITY
STATE
ZIP CODE
COUNTY
___ ___ ___ ___ ___
11. CLOSE THE FOLLOWING BUSINESS LOCATION FOR:
SALES TAX
CONSUMER’S USE TAX
VENDOR’S USE TAX
EMPLOYER WITHHOLDING TAX
BUSINESS NAME
STREET OR HIGHWAY ADDRESS (DO NOT USE PO BOX, RURAL ROUTE, HCR, ETC.)
M
M
D
D
Y
Y
Y
Y
CITY (ENTER “UNINCORPORATED” IF NOT WITHIN A CITY’S LIMITS)
STATE
ZIP
COUNTY
DATE OF
CLOSING
__ __ __ __ __
12. OPEN THE FOLLOWING NEW PHYSICAL BUSINESS LOCATION FOR:
SALES TAX
CONSUMER’S USE TAX
VENDOR’S USE TAX
EMPLOYER WITHHOLDING TAX
BUSINESS NAME
STREET OR HIGHWAY ADDRESS (DO NOT USE PO BOX, RURAL ROUTE, HCR, ETC.)
M
M
D
D
Y
Y
Y
Y
CITY
STATE
ZIP
COUNTY
TAXABLE
SALES BEGIN
__ __ __ __ __
DATE
(To find out if this location is inside the city limits or in a district, go to https://dors.mo.gov/tax/strgis/index.jsp)
Is this business located inside the city limits of any city or municipality in Missouri?
No
Yes — Specify the city: ________________________________________________________________________________________
Is this business located inside a district(s)? For example, ambulance, fire, tourism, community or transportation development.
No
Yes — Specify the district name(s): ________________________________________________________________________________
DO YOU LEASE/RENT MOTOR VEHICLES FROM THIS LOCATION, THAT WERE PURCHASED SALES TAX EXEMPT, TO MISSOURI CUSTOMERS? . . . .
YES
NO
DO YOU SELL POST-SECONDARY EDUCATIONAL TEXTBOOKS? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU SELL FOOD ITEMS FROM THIS LOCATION THAT ARE EXEMPT FROM STATE SALES TAX? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU SELL DOMESTIC UTILITIES AT THIS LOCATION? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU SELL CIGARETTES OR OTHER TOBACCO PRODUCTS FROM THIS LOCATION? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU MAKE RETAIL SALES OF AVIATION JET FUEL TO MISSOURI CUSTOMERS? (PLEASE PROVIDE A LIST OF ALL APPLICABLE LOCATIONS AND
ANSWER QUESTIONS A AND B FOR EACH LOCATION) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
A. If yes, are your sales made at:
(1) an airport located in Missouri? (Your account will be registered for retail sales tax) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
(2) a location outside Missouri and the fuel is transported into Missouri? (Your account will be registered for vendor’s use tax). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
B. Is the airport located in Missouri identified on the National Plan of Integrated Airport Systems (NPIAS)? (Your account will be registered for retail sales of
aviation jet fuel). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU USE, STORE, OR CONSUME AVIATION JET FUEL IN MISSOURI WHERE THE SELLER DOES NOT COLLECT TAX? . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
If yes, is the fuel stored, used, or consumed in an airport that is eligible to apply for federal grant funds? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
(If yes, your account will be registered for consumer’s use tax of jet fuel. Please provide a list of applicable locations)
____________________________________________________________________________________________________
DO YOU MAKE RETAIL SALES OF NEW TIRES? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU MAKE RETAIL SALES OF LEAD-ACID BATTERIES? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU MAKE RETAIL SALES OF QUALIFYING SALES TAX HOLIDAY BACK-TO-SCHOOL PURCHASES? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU MAKE RETAIL SALES OF ENERGY STAR CERTIFIED APPLIANCES THAT QUALIFY FOR THE “SHOW ME GREEN SALES TAX HOLIDAY”? . . . .
YES
NO
DO YOU PROVIDE TELECOMMUNICATIONS SERVICE SUBJECT TO MISSOURI RETAIL SALES TAX? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU MAKE RETAIL SALES OF QUALIFYING UTILITIES OR ITEMS USED OR CONSUMED IN MANUFACTURING OR MINING,
RESEARCH AND DEVELOPMENT OR PROCESSING RECOVERED MATERIALS? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
DO YOU SELL ANY TYPE OF ALCOHOLIC BEVERAGE? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
COMMENTS
UNDER PENALTIES OF PERJURY, I DECLARE THAT THE ABOVE INFORMATION AND ANY ATTACHED SUPPLEMENTS ARE TRUE, COMPLETE, AND
CORRECT. ADDING PERSONS TO THE ACCOUNT INDICATES THEY HAVE DIRECT SUPERVISION OR CONTROL OVER TAX MATTERS. THE APPLICATION
MUST BE SIGNED BY THE OWNER, IF THE BUSINESS IS A SOLE OWNERSHIP; PARTNER, IF THE BUSINESS IS A PARTNERSHIP; REPORTED OFFICER, IF
THE BUSINESS IS A CORPORATION, OR BY A MEMBER IF THE BUSINESS IS A L.L.C AS REPORTED ON THE APPLICATION.
SIGNATURE
PRINTED NAME
No digital signatures allowed
TITLE
DATE(MM/DD/YYYY)
__ __ / __ __ / __ __ __ __
RETURN THIS FORM TO: TAXATION DIVISION, PO BOX 3300, JEFFERSON CITY, MO 65105-3300
IF YOU HAVE QUESTIONS: Phone: (573) 751-5860 TDD (800) 735-2966 FAX: 573-522-1722
E-mail: businesstaxregister@dor.mo.gov
DOR-126 (02-2013)
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