New Account Application/business Questionnaire Form
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PLEASE COMPLETE ENTIRE FORM
BUSINESS QUESTIONNAIRE
NEW ACCOUNT APPLICATION / BUSINESS QUESTIONNAIRE
Phone:
513 785-7400
CITY OF HAMILTON
CHECK APPROPRIATE CITY
Toll Free: 1 800 854-1684
INCOME TAX DIVISION
HAMILTON – 2%
PHILLIPSBURG – 1.5%
J.E.D.D. – 2%
Fax:
513 785-7401
345 High Street, Suite 310
EATON – 1.5%
J.E.D.D. II – 2%
Email:
citytax@ci.hamilton.oh.us
Hamilton, Ohio 45011
NEW MIAMI – 1.75%
WEST MILTON – 1.5%
BUTLER COUNTY ANNEX - 2%
Website:
USE A SEPARATE FORM FOR EACH CITY
Please assist us in completing your account information. If you should have any questions while completing this form, please
contact our office. Mail or fax within 10 business days. Thank you for your cooperation.
1. Name _______________________________________________
Phone # __________________________________
2. Trade Name (DBA) ____________________________________
Fax # ____________________________________
3. Federal ID # or Soc Sec # _______________________________
Email ____________________________________
4. Address _________________________________________________________________________________________
5. Name and address where tax forms are to be sent (if different from above)
________________________________________________________________________________________________
6. Check whichever is applicable:
Indiv. Proprietorship (Sch C)
Non-profit organization
Partnership
Corporation
Other (explain) __________________________________________________________________
7. When does your fiscal year end? Give month and day
(Note: a fiscal year ending must be the same as your federal return.) _________________
8. Give date business and/or withholding began in this city ______________
9. Do you have employees working in the city indicated at the top of this form?
Yes - If yes, Approximate # _______
No
10. Is your company only withholding city income tax as a convenience for resident employees?
Yes (Go to Signature Line)
No (Complete entire form)
11. Will you be using subcontractors?
Yes - If yes, Approximate # _______
No
If yes, submit a list of all subcontractors to
citytax@ci.hamilton.oh.us
or by fax to 513-785-7401 (Include: Business name,
Address, Contact name, Phone # and Nature of work being performed).
12. Nature of the companies work: (Check all that apply)
Supplying Materials
Installation
Construction
Professional (architect, accountant, engineering, or lawyer)
Other - Describe in Detail ______________________________________________________________________________
13. If a partnership, please give name, address, and social security numbers of all partners.
if more space is required, you may submit the listing to citytax@ci.hamilton.oh.us.
________________________________________________________________________________________________
________________________________________________________________________________________________
14. If you operate more than one place of business or own rental property, please give name
and/or location of each. If more space is required, you may submit the listing to
citytax@ci.hamilton.oh.us
________________________________________________________________________________________________
________________________________________________________________________________________________
15. If the work is performed offsite, please supply the address
________________________________________________________________________________________________
Contact Person __________________________________ Date __________ Phone # _________
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Parent category: Financial