Business And Professional Questionnaire Form printable pdf download

Business And Professional Questionnaire Form

THE CITY OF MANSFIELD

INCOME TAX DIVISION

30 N. DIAMOND STREET

TELEPHONE: (419) 755-9711

P.O. BOX 557

FAX: (419) 755-9751

MANSFIELD, OHIO 44901

BUSINESS AND PROFESSIONAL QUESTIONNAIRE

For the purpose of our records, with regard to Mansfield Income Tax, Please complete and

return this Questionnaire promptly.

Local name and address as used for business purposes:

___________________________________________________________________

Trade Name: ________________________________________________________

Location in Mansfield or work site: ______________________________________

Date started in Mansfield: _____________________________________________

Federal I.D. or Social Security #: ________________________________________

Accounting Period used for federal income tax purposes:

(Check applicable box-if fiscal write in date)

___ Calendar Year ending December 31

___ Fiscal Year ending ____________

Do you now employ one or more persons in Mansfield? ____Yes ____No

Date Employees Started in Mansfield: ____________________________________

Do you expect to have employees in the future? ____Yes ____No

When? ____________________________________________________________

Does your company voluntarily withhold tax for Mansfield residents not employed inside the City of

Mansfield? (If yes, only complete the front of this form) ____Yes ____No

Company Phone: _____________________

Fax: _____________________

Send Business net Profit Return:

Send Withholding Tax Form:

Name: ______________________________

Contact Person: _______________________

Street Address: _______________________

City: ____________ State____ Zip _______

Business And Professional Questionnaire Form