Form St-1 - Application For Vendor'S License To Make Taxable Sales - 2000
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1S
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Prescribed Sales Tax Form
TATE OF
HIO
ST-1 (
)
Rev. 9/00
D
T
EPARTMENT OF
AXATION
License Number Assigned
A
V
'
L
by County Auditor
PPLICATION FOR
ENDOR
S
ICENSE
M
T
S
TO
AKE
AXABLE
ALES
To the Auditor of _______________________ County
Date ________________
Pursuant to Section 5739.17 Revised Code of Ohio, I/we herewith make application for a license to make taxable sales at the following
location. For sole owner, print individual's name; for partnership, print full names of all partners; for corporation, print corporation's name and
Ohio corporation charter number. If a foreign corporation, print certificate number issued by Secretary of State authorizing transaction of
business in Ohio. Section 1703.01 O.R.C.
_________________________________________________________
# __________________________
name
corporation charter
_________________________________________________________________________________________________
trade name or dba, if other than above
_________________________________________________________________________________________________
business address
_________________________________________________________________________________________________
city
state
zip code
telephone number
_________________________________________________________________________________________________
kind of business
code number
__________________________________ County Auditor
by ____________________________ Deputy
NOTE: The County Auditor shall not issue vendor's license until all questions pertaining to the applicant on this application are answered.
Application and payment of the $25.00 application fee is to be forwarded to the Auditor of the County in which the sales are to be
made.
1.
Mailing Address (if other than above)
________________________________________________________________________________________________
street
city, town, village
state
zip code
2.
Residence Address of Vendor or Home Office of Corporation
________________________________________________________________________________________________
street
city, town, village
state
zip code
3.
Federal Employer Identification Number or if none
Employer Identification No.
Social Security No.
assigned for reporting Federal Taxes, please enter
your Social Security Number.
q
q
q
4.
Check type of ownership:
0.
Corporation
1.
Sole Owner
2.
Partnership
q
q
q
3.
Fiduciary
4.
Association
5.
Business Trust
5.
If vendor is a corporation, show officers' names and addresses below.
President ________________________________________________________________________________________
name
street
city/state
Vice-Pres ________________________________________________________________________________________
name
street
city/state
Secy/Treas _______________________________________________________________________________________
name
street
city/state
6.
When did or will you start making taxable sales at this location? ______________________________________________
7.
________________________________________________________________________________________________
name
address
vendor's license number of previous owner
8.
Will you be selling beer, wine or liquor at this location: Yes ____ No ____ If a holder of permit(s) issued by the Dept. of
Liquor Control, state permit class ___________________ and number ____________________
9.
Approximately how much sales tax do you expect to collect each month?
$ _____________________________
10.
If two or more stores are operated and you file returns under cumulative return authority, what is your Master Number?
____________________________________________________
I hereby declare the above to be true and correct to the best of my knowledge and belief.
__________________________________________
signature of vendor or agent
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