Form Q 1 - Business And Professional Questionnaire - Village Of Octa printable pdf download

FORM Q1

VILLAGE OF OCTA

INCOME TAX DEPARTMENT

BUSINESS AND PROFESSIONAL QUESTIONNAIRE

For the purpose of our records, with regard to the Village of Octa Income Tax, please complete and return this

questionnaire promptly to the Village of Octa, Income Tax Department, P. O. Box 63, Milledgeville, OH 43142

NAME_________________________________________________________________________________

ADDRESS______________________________________________________________________________

CITY __________________________________ STATE ___________________ ZIP CODE____________

Federal Identification No.__________________________

1. Local Name and Address as used for business purposes:

Trade Name__________________________________________________________________

Address_____________________________________________________________________

Mailing Address (If different than above)___________________________________________

Federal ID or Social Security No._________________________________________________

2. Is above address Main Office or Branch Office?______________________________________

If Branch, give name and address of Main Office:

Name______________________________________________________________________

Address____________________________________________________________________

3. Nature of Business_____________________________________________________________

4. Accounting period used for Federal Income Tax Purposes:

( ) Calendar year ending December 31 (

) Fiscal year ending ______________________

5. Do you employ one or more persons?_____________________________________________

6. Estimated No. of employees and annual payroll._____________________________________

7. Type of Ownership:

(

) Proprietorship ( ) Corporation ( ) Partnership ( ) Association

8. If partnership, association, or other unincorporated joint business venture, indicate

how the Octa Village Tax Return (upon the net profit) will be filed and paid:

( ) In full by the business ( ) Separately by the individual members on

proportionate shares

9. Owner's Name and Address:

(A) If individual proprietorship: (B) If corporate subsidiary, give Name and Address of

Parent Company’s Main Office:

Name ________________________ Name ________________________________

Address _______________________ Address ______________________________

______________________________ _____________________________________

(Please Complete Questions On Next Page)

Form Q 1 - Business And Professional Questionnaire - Village Of Octa