Questionnaire Form - Division Of Taxation - City Of Sylvania

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Questionnaire
Division of Taxation
City of Sylvania, 6730 Monroe St, Sylvania OH 43560-1949
Phone: (419) 885-8940
Fax:
(419) 885-3442
Please provide your business name, address and phone number:
Name: ________________________________________________________________________________________
Address: ______________________________________________________________________________________
City: __________________________ State: _____ Zip Code: __________ Phone Number: _________________
The information contained on this form is necessary to open any city tax accounts needed by your company. A
response is required within five (5) days. Sylvania city income tax rates are 1 ½% for payroll withholding and net
profit taxes.
ALL INFORMATION IS CONFIDENTIAL PER THE SYLVANIA CITY ORDINANCES, SECTION 171.09 (d).
Check classification of business: Sub S _____ Corporation _____ Partnership _____ Proprietorship _____
LLC _____ LLP _____ What federal form will you be filing? _____________________________________
List name and address of owners: __________________________________________________________________
______________________________________________________________________________________________
Federal I.D. number: ____________________________
A Social Security number is needed if you will be filing a Federal Schedule C: _____________________________
Type of work performed: _________________________________________________________________________
Will you have sub-contractors? _____ If yes, please provide a list of their names and addresses.
Date operation started in Sylvania: _________________ Date business year ends: ____________________
Address of Sylvania business location: _______________________________________________________________
Are there now or will there be employees subject to Sylvania income tax: ___________ If so, please show the
payroll starting date: _______________
Check the reason for the payroll: Work performed inside city limits _____ Courtesy for Sylvania residents _____
Will you be using a payroll service? Name _________________________________________________________
Trade name: ___________________________________________________________________________________
Is this business an outgrowth of another business? __________ If so, please provide the names of the business &
owners: _______________________________________________________________________________________
______________________________________________________________________________________________
If the address to mail tax forms is different from the address shown above, please provide the correct information:
______________________________________________________________________________________________
Name, address & phone number of the person who prepares your tax forms: _________________________________
______________________________________________________________________________________________
By signing this form, I give the Sylvania tax office permission to contact my accountant.
I CERTIFY THE ABOVE TO BE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
Signed: _________________________________ Title: ______________________________ Date: ______________

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