Form Tc-69 - Business And Tax Registration October 2001 (Page 3 of 4) in pdf

Section 3 – Employer Withholding

When will or did you start paying wages?

Corporations: Refer to IRS PUB 15-A to determine requirements for withholding

Month

Day

Year

payroll taxes from wages paid to officers. Generally, an officer is an employee, but

a director is not. An officer who performs no services or only minor services, and

neither receives nor is entitled to receive any pay, is not considered an employee.

If you have multiple business locations, also complete Section 7

Section 4 – Sales and Use Tax

4a. When will you start selling or making purchases?

4b. Estimate your monthly sales and purchases subject to tax

Month

Day

Year

$1,000 or less

$1,001 to $5,000

$5,001 to $10,000

Over $10,000 (specify) $________________

4c.

Read and review all questions below. Check all boxes for which your answer is “yes.”

Sales and use tax is reported on forms in the TC-71 series, in addition to the following schedules and/or forms.

Schedules or Forms

Will you sell goods or services from only a single place of business in Utah?

Will you sell goods or services from more than one place of business in Utah (complete Section 6)? ............................... Schedule A

Will you sell goods or services from a non-fixed place of business such as door-to-door or through

vending machines or multi-level marketing? Also check this box if your business is located in Utah and

you ship goods from a location outside Utah to a Utah customer. ..................................................................................... Schedule B

Are you a real property contractor bringing material directly to a Utah job site and/or having material

shipped direct to a Utah job site from a location outside Utah? ......................................................................................... Schedule B

Will you purchase goods or services tax-free from vendors located outside Utah for storage, use,

or consumption in Utah? .................................................................................................................................................... Schedule B

Are you a vendor who has no physical or representational presence in Utah who is selling goods or

services shipped by U.S. Mail or common carrier directly to Utah customers? See Pub 37, “Business

Activity and Nexus in Utah.” DO NOT MARK THIS BOX IF YOU HAVE CHECKED ANY OTHER BOXES. ..................... Schedule C

Are you a public utility? .................................................................................................................................................... Schedule D

Are you selling motel, hotel, trailer court, campground or other lodging accommodations? ......................................... Form TC-71T

Will you have restaurant sales or sales of prepared foods or beverages? ...................................................................... Form TC-71F

Will you rent motor vehicles to customers for less than 30 days, registered for 12,000 pounds or less? .................. Form TC-71FV

10.

Will you have retail sales of new tires? This includes new tires sold as part of a vehicle sale, new tires

11.

purchased on or for vehicles that are rented, or new tires purchased from all those not collecting the

Waste Tire Recycling Fee. ................................................................................................................................................. Form TC-71W

Is your business located in a resort community: Alta, Boulder, Brian Head, East Green River,

12.

Green River, Kanab, Moab, Monticello, Panguitch, Park City, Springdale, or Tropic? ...................................................... Form TC-71R

If only boxes 4 and/or 5 are checked, an “H” prefix number will be issued. An “H” number is only for reporting

tax-free purchases from outside Utah and may not be used to purchase tax free from Utah vendors.

Required by all applicants

Section 5 – Authorized Signature(s)

Required by all applicants.

I understand that any persons (including employees, corporate directors, corporate officers, etc.) who have the authority to direct accounting

processes or who are required to collect, account for, and pay any taxes and fail to do so shall be liable for a penalty equal to the total

amount of tax not collected, not accounted for, or not paid under the provisions of UCA §59-1-302.

I also understand that I am required to notify the Utah State Tax Commission, in addition to the Utah Department of Commerce, if I add or

close a business location; or change the name, organizational structure, officer status, or address of the business.

Sign Here: ______________________________________________________

Title: ____________________

Print Name: ______________________________________________________

Date: ____________________

Two signatures are required when registering a DBA for a general partnership.

Sign Here: ______________________________________________________

Title: General Partner

Print Name: ______________________________________________________

Date: ____________________

If a sole proprietor, signature must match SSN provided in Section 1, 1d (e.g., a husband or wife may not sign on behalf of each other). If a general

partnership, two partners must sign for registration of the DBA, or one partner for tax registration. If a corporation, an officer of the corporation autho-

rized to sign on behalf of the corporation must sign; if a limited liability company, a member must sign; if a trust, the grantor or a trustee must sign.

Form Tc-69 - Business And Tax Registration October 2001 Page 3

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