Form 80-001 - Iowa Motor Fuel Tax License Application

Form 80-001 - Iowa Motor Fuel Tax License Application - 2002

80-001

I O WA

Iowa Motor Fuel Tax License Application

(4/23/02)

d e p a r t m e n t o f R e ve n u e a n d F i n a n c e

I. LOCATION NAME/ADDRESS

IV. TYPES OF MOTOR FUEL LICENSES

EFT required/You must complete form 90-302.

EFT required/You must complete

form 90-302.

EFT required/You must complete form 90-302.

II. MAILING NAME/ADDRESS

V. CURRENT/PRIOR BUSINESS ACTIVITY

III. TYPE OF OWNERSHIP (check one)

Sole Proprietor

Partnership

Do you currently operate a business at another location in Iowa?

Corporation

Association

YES

If yes, complete the following:

Government

Limited Liability Co.

Incomplete applications delay processing.

FOR OFFICE USE ONLY

PERMIT NUMBER

Did you previously have an Iowa Motor Fuel license?

YES Number: ___________________

_________________________________

VI. SIGNATURE

_________________________________

This application must be signed by the owner,

_________________________________

one of the partners or a corporate officer.

_________________________________

CONTINUE ON OTHER SIDE

Form 80-001 - Iowa Motor Fuel Tax License Application - 2002