Form 1 - Town Of Eva Tax Application& Information Form

Form 1 - Town Of Eva Tax Application& Information Form - 2014

TOWN OF EVA TAX APPLICATION& INFORMATION FORM

(CONFIDENTIAL)

MAIL TO: TOWN OF EVA

PHONE: (256) 351-4618

P.O. BOX 456

DECATUR, AL 35602

ACCOUNT NUMBER: ____________________(THIS IS ASSIGNED BY OUR OFFICE)

BUSINESS NAME: ________________________________________________________

TYPE OF BUSINESS: ______________________________________________________

LOCATION OF BUSINESS: _________________________________________________

STREET

CITY

STATE

ZIP

MAILING ADDRESS: ______________________________________________________

STREET

CITY

STATE

ZIP

TELEPHONE (_____)________________________(_____)_________________________

BUSINESS/HOME

FAX

MANAGER’S or OWNER’S NAME: ___________________________________________

FEIN# or SSN#: ______________________________________________________

CONTACT PERSON FOR TAX QUESTIONS: ____________________________________

EMAIL ADDRESS: _________________________________________________________

WHERE YOUR BUSINESS IS LOCATED / IMPORTANT, ANSWER YES OR NO.

IS YOUR BUSINESS LOCATED INSIDE THE CORPORATE LIMITS OF EVA?

YES ____

NO ____

I AFFIRM UNDER THE PENALTY OF PERJURY THAT THE ABOVE IS A TRUE AND CORRECT

STATEMENT TO THE BEST OF MY KNOWLEDGE AND BELIEF.

DATE________________

SIGNATURE: ________________________________

TITLE: ______________________________________

BUSINESS START DATE: __________________________________

IMPORTANT, RETURN TO SALES TAX OFFICE WITHIN 10 DAYS

OR ATTACHED TO YOUR FIRST RETURN

Form 1 - Town Of Eva Tax Application& Information Form - 2014