Income Tax Form Business And Professional Questionnaire - City Of Wapkoneta printable pdf download

Income Tax Form Business And Professional Questionnaire - City Of Wapkoneta

CITY OF WAPAKONETA

INCOME TAX DEPARTMENT

701 PARLETTE CT, P. O. BOX 269

WAPAKONETA, OHIO 45895-0269

(419) 738-7342

(419) 738-4762 Fax

BUSINESS AND PROFESSIONAL QUESTIONNAIRE

Please complete this questionnaire and return it to the Income Tax Department. Information provided will be

used exclusively for income tax purposes and will not be further disclosed.

Name ______________________________________ dba _________________________________________

Address _____________________________________City/State/Zip_________________________________

Telephone # ___________________ Fax # ___________________ E-Mail ___________________________

Federal Employer ID or Social Security No. _____________________________________________________

Nature of business conducted: ________________________________________________________________

Accounting method (check one) [ ] calendar year ending December 31 [ ] fiscal year ending _____________

Do you now employ one or more persons? _____ If yes, how many? _______ If no, will you? __________

Date that your business began operating within the City of Wapakoneta ________________________________

Type of ownership:

[ ] Proprietorship

[ ] Partnership

[ ] S Corp

[ ] Non-profit Corporation

[ ] C Corp

[ ] Other – Specify ______________________

If the business is located outside of the City of Wapakoneta, are you withholding income taxes as a courtesy for

your employees?

Address to which tax forms, notifications and official correspondence are to be mailed:

Business Name________________________________________ Attention ____________________________

Address ______________________________________ City/State/Zip________________________________

Phone Number (_____) ______________________

Fax Number (______) _______________________

Signature of individual completing form and title __________________________________________________

Printed Name ___________________________________

Date _____________________

Acct No. ______________________

Income Tax Form Business And Professional Questionnaire - City Of Wapkoneta