Business Tax Application
Page 3a
(Please print legibly or type the information on this application.)
Section D: Food and Beverage Tax Registration (see instructions on page 2)
(No Registration Fee)
Contact the Department at (317) 233-4015 for more information regarding this tax.
Contact the Department at (317) 233-4015 for more information regarding this tax.
County
Municipality
2. Will prepared foods or beverages be catered
Date of first sales at this location under this
1.
(City or Town)
ownership:
from this location into other counties?
1. _______________
_______________
Yes
No
3. If yes, enter the name(s) of the county(ies)
2. _______________
_______________
Month
Year
and associated municipality.
3. _______________
_______________
4. _______________
_______________
Section E: County Innkeepers Tax Registration (see instructions on page 2)
(No Registration Fee)
Contact the Department at (317) 233-4015 for more information regarding this tax.
1. Date room rentals or accommodations begin
from this location:
Month
Year
Section F: Motor Vehicle Rental Excise Tax Registration (see instructions on page 3)
(No Registration Fee)
Contact the Department at (317) 233-4015 for more information regarding this tax.
1. Date motor vehicle rental or leasing begins:
Month
Year
2. If the address shown on Section A, Line 9 is in Indiana, make sure that a tax district number has been entered on that line.
3. If you are renting or leasing from a location outside Indiana and the vehicles carry Indiana plates, enter the tax district number(s) to receive excise tax credit:
______________________
______________________
______________________
______________________
Section G: Prepaid Sales Tax on Gasoline for Qualified Distributors (see instructions on page 3)
($100.00 Registration Fee)
Contact the Department at (317) 232-3524 for more information regarding this tax.
1. Enter your Indiana licensed gasoline distributor number:
2. Date of first gasoline sale:
3. Estimated number of gallons purchased/sold monthly:
4. Mailing name and address for prepaid sales tax returns (if different from Section A, Line 3):
Month
Day
Year
In care of:
Street Address:
City:
State:
Zip Code:
5. Name of contact person:
6. Contact Person’s Daytime Telephone Number:
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