Municipal Income Tax Business Questionnaire Form

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CITY OF RAVENNA, OHIO
P.O. Box 1215 - Ravenna, OH 44266-1215
Income Tax Department
Phone: (330)297-7817; Fax: (330)297-2164
Municipal Income Tax Business Questionnaire
Date:
Please complete and return this Questionnaire within ten (10) days. Attach additional information as necessary.
LOCAL INFORMATION
Business name:________________________________________ DBA:_______________________________________
Local business address:__________________________________________________________________Ravenna, OH 4
Local business phone no:_______________________________
Local business fax no:___________________________
Date business started in Ravenna:________________________ Have you previously filed with Ravenna: Yes___ No___
Principal business activity (as listed on federal forms):______________________________________________________
Name of accounting firm preparing your forms:___________________________________________________________
Address of accounting firm:___________________________________________________________________________
Do you make rent or lease payments: Yes____ No____
If yes, attach name and address of landlord(s).
Do you rent or lease real property to others: Yes____ No____
If yes, attach name and address of tenant(s).
PARENT COMPANY INFORMATION - If you are a corporate subsidiary
Main office address:_________________________________________________________________________________
__________________________________________________________________________________
Main office phone no:_____________________________ Main office fax no:___________________________________
FILING INFORMATION - check which applies
_____ C Corporation
Federal ID no:_________________________________
Fiscal year-end:__________________________
Mailing address for business return:______________________________________________________________
_______________________________________________________________
_____ S Corporation
Federal ID no:_________________________________
Fiscal year-end:__________________________
President name:________________________________
Vice President:______________________________
Mailing address for business return:______________________________________________________________
_______________________________________________________________
_____ Partnership
Federal ID no:_________________________________
Fiscal year-end:__________________________
Name/address:______________________________________________ SS#:____________________________
Name/address:______________________________________________ SS#:____________________________
Name/address:______________________________________________ SS#:____________________________
Mailing address for business return:______________________________________________________________
_______________________________________________________________
_____ Sole Proprietorship
Federal ID no:_________________________________
(if applicable) SS#:____________________________
Owner name:________________________________________________ Home ph no:_____________________
Owner address:______________________________________________________________________________
Mailing address for business return:______________________________________________________________
_______________________________________________________________
EMPLOYEE WITHHOLDING INFORMATION
Will you be withholding more than $100.00 per month in city taxes:
Yes_____ No_____ Voluntary withholding:______
Present number of employees in Ravenna:___________
Expected number of employees at end of fiscal year:_________
Date employees starting working in Ravenna:_____________________
Person responsible for payroll records:_________________________________________________Phone no:_________
Mailing Address for forms:____________________________________________________________________________
If you are using a payroll service, please indicate which one:_________________________________________________
Thank you for your assistance,
City of Ravenna Income Tax Department

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