Form W - Income Tax Division

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W
CITY OF BOWLING GREEN, OHIO
TAX RATE 1.92%
INCOME TAX DIVISION
304 NORTH CHURCH STREET
BOWLING GREEN, OH 43402-2399
PHONE (419)354-6212
e-mail:
FAX (419)354-5122
Web:
Please complete and return this questionnaire promptly so that our records will correctly reflect your tax compliance
obligations in this city and so that we can provide proper forms in a timely manner. Thank you.
1. Company and Trade Name _______________________________________________ EID No. _________________
2. Name of Officer (If a Corporation) and Title___________________________________________________________
3. Name of Owner(s) _____________________________________________________ Soc. Sec __________________
4. Mailing Address_
________________________________________________Phone ____________________
(
)
Street/PO Box
_(City/State/Zip)______________________________________________________________________ FAX
____________________________
5.
________________________________________________ Phone ____________________
B.G. Address/Work Location
6.
_______________________________________________ Phone ____________________
Accountant Name and Address
7. Starting Date of Bowling Green Activities_______________ If temporary, anticipated ending date ______________
8. Type of Organization: Individual Proprietor _______; Partnership _______; Corporation _______;
LLC _____ (Sole Proprietor _____ or Partnership _____ or Corporation _____); Sub-S Corporation _______;
Non-Profit Corporation _______; Association _______
If a partnership, list on the back of this form the names and addresses of all partners.
If “S” Corporation, list on the back of this form the names and address of all shareholders.
9. A. Do you have employees working in Bowling Green? Yes
(
*
)
_______ No _______
OR
(
)
B. Are you withholding BG taxes for BG residents who work outside of BG? Yes
*
______ No ______
(
*
)
If Yes, what date did you begin BG city tax withholding ____________________
10. Accounting Period: Calendar Year (Y/N) _______
OR
Fiscal Year Ending (mm/dd)_________________
11. Nature of business ______________________________________________________________________________
12. Is this local address the Home Office or a Branch _____________________________________________________
13. If no Bowling Green address, do you have net profit/loss attributable to Bowling Green? Yes_______ No _______
your email address: ____________________________________________
If Business Was Outgrowth of Another, Please Complete the Following:
14. Name of former owner(s) _________________________________________________________________________
15. Trade Name (If Any) __________________________________________________________ ID #______________
16. Mailing Address ________________________________________________________________________________
17. Type of Organization:
Individual ____ Partnership ____ Corporation ____ S Corporation ____ Association ____
18. Nature of change: Sale ________ Discontinuance ________ Change in Organization _________ Other _________
Date ___________________________________________ Signature _________________________________________
Title _____________________________________________

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