Form 20 - Tax Application Form - State Of Nebraska - 2014

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Important Message
Nebraska Tax Application
Form
20
1 Do you hold, or have you previously held a Nebraska
Please Do Not Write In This Space
3 County of Business Location Within
ID number?
Nebraska
c 
c 
Yes
No
If Yes, provide the number:
RESET FORM
PRINT FORM
2 Federal Employer ID Number (EIN)
4 For Department Use Only
Name and Location Address of Business
(print clearly)
Name and Mailing Address
Name Doing Business As (dba)
Name
Legal Name
Business Street Address (Do Not Use PO Box)
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
5 Name and Address of Legal Entity/Owner
c
c
Is your Nebraska location within the city limits?
(1)
Yes
(2)
No
6 Identify Owner and Spouse (if joint ownership), Partners, Members, or Corporate Officers (one of the listed individuals must sign as applicant).
Social Security Number
Name, Address, City, State, Zip Code
Title, If Corporate Officer
7 Type of Ownership
(1)
Sole Proprietorship
(5)
Foreign Corporation (another state or country)
(9)
Nonprofit Organization
c
c
c
(2)
c
Partnership
(6)
c
S Corporation
(10)
c 
Cooperative
(3)
Nonprofit Corporation
(7)
Governmental
(11)
Limited Liability Company
c
c
c 
(4)
Corporation
(8)
Fiduciary (Estate or Trust)
c
c
8 Accounting Basis
9 Accounting Period (Type of Year) (see instructions)
(1)
Cash
c
(1)
Calendar – January 1 to December 31
c
(2)
Accrual
c
(2)
c
Fiscal – 12 Month Ending
(3)
Other
c
(3)
Fiscal – 52 or 53 Week Ending
c
10 Location of Records
(1)
Same as Location Address
(3)
Other Address (provide below)
c
c
(2)
c
Same as Mailing Address
Address
City
State
Zip Code
11 Reason for Filing Application – Check Appropriate Boxes. If box 3 is checked, you may cancel your old Nebraska ID number on the final
return, on a Form 22, or by providing the number and final date in box 3 below.
(1)
c
Original Application
(3)
c
Changed Business Entity (To cancel Nebraska ID number
(4)
c 
Add Tax Program
(2)
Change in Partners
of previous entity, write the ID number and final date here:
(5)
Other (attach explanation)
c
c 
ID #_________________________ Date_______________)
From -
To -
Sole Proprietorship
Sole Proprietorship
c 
c 
c 
Partnership
c 
Partnership
Limited Liability Company
Limited Liability Company
c 
c 
Corporation
Corporation
c 
c 
12 Provide a description of your business operations, products that you sell, and services that you provide.
a. Primary business type:
c 
Retailer
c 
Lessor
c 
Wholesaler
c 
Manufacturer
c 
Construction Contractor
c 
Other
If you marked “Lessor” , do you lease motor vehicles to others for periods of longer than 31 days?
c 
Yes
c 
No
b. If your business does not operate year-round, identify the months you operate.
c. How many business establishments do you operate: in Nebraska?
in U.S.A.?
d. If you purchased an existing business, identify the previous owner.
Name
Address
City
Zip Code
Nebraska ID Number
Complete Reverse Side
11-2014
7-100-1975 Rev.
Supersedes 7-100-1975 Rev. 9-2014

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