Form Tc-69 - Business And Tax Registration October 2001
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4TC-69
UTAH STATE BUSINESS AND TAX REGISTRATION
Rev. 10/01
Form TC-69 is used to register with the Utah State Tax Commission for the taxes outlined below. In addition to tax registration, applicants
may also register a DBA (“Doing Business As”) with the Utah Department of Commerce on this form. For registration of a DBA only, do not
complete this form. Use Department of Commerce form, “Business Name Registration / DBA Application,” available at all registration
locations, on line at , or by telephone at (801) 530-4849.
When completing this form:
Utah State Tax Commission
210 North 1950 West
• Read the instructions carefully.
Salt Lake City, Utah 84134-3310
• Type or print clearly.
(801) 297-2200
• Be advised, applications with missing or illegible information will be returned.
1-800-662-4335
Fax: (801) 297-3573
• Mail or fax the completed application to the Tax Commission (address at right).
• Allow 15 business days for processing.
Office Use Only (USTC)
Type of Registration
ü
Check each box that applies
Fee
Complete Sections
Business Name / DBA
$20
1, 2, 5
(make check payable to State of Utah)
Employer Withholding
No Fee
1, 3, 5
(see Section 1, 1a)
Sales and Use Tax License
No Fee
1, 4, 5, 6
(see Section 1, 1a)
Lubricating Oil Fee
No Fee
1, 5
* The minimum amount of bond
is $500 for cigarettes or tobacco, or
Beer Tax
No Fee
1, 5
$1,000 for both. Contact an
Cigarette and Tobacco License
$30 per location
1, 5, 6
insurance company of your choice
(make check payable to Utah State Tax Commission)
to obtain a surety or performance
bond. Attach the bond to the
Cigarette Stamper
License and Bond*
1, 5
application, or forward the bond
Tobacco Products
License and Bond*
1, 5
after submitting the application.
If you purchase a business, obtain from the seller a letter from the Tax Commission stating no sales and use tax is due; or
withhold enough of the purchase money to cover all unpaid taxes. If you fail to withhold sufficient funds from the purchase money,
you will be held personally liable for the seller’s unpaid sales and use tax, including all sales-related taxes (UCA §59-12-112).
Section 1 – General Information
Required by all applicants.
1a. Existing Accounts Applicants for sales or withholding accounts may
be required to post a bond upon review of prior filing history. Enter any
existing or previous tax accounts with the Utah State Tax Commission: _________________________________________________
1b. Organizational Structure Must check one
Individual/Sole Proprietor
Limited Partnership
Limited Liability Company
Corporation
General Partnership
Limited Liability Partnership
Business Trust
S Corporation
(attach approval of election by IRS)
1c. Incorporation Date If a corporation, enter the date: ____________ and state: ______ of incorporation or qualification in Utah.
1d. Federal Identification Number
A sole proprietor is required to provide a Social Security Number (SSN). In addition, a sole proprietor with employees is required to
provide an Employer Identification Number (EIN). All other organizational structures must provide an EIN.
Social Security Number (SSN)
Federal Employer Identification Number (EIN)
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