Certificate Of Good Standing Application For A Liquor License Renewal Form printable pdf download

Certificate Of Good Standing Application For A Liquor License Renewal Form

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS

DEPARTMENT OF ADMINISTRATION

DIVISION OF TAXATION

ONE CAPITOL HILL

PROVIDENCE RI 02908-5812

CERTIFICATE OF GOOD STANDING APPLICATION FOR A LIQUOR LICENSE RENEWAL

TAXPAYER NAME

DBA

ADDRESS

CITY, STATE, ZIP

A CERTIFICATE OF GOOD STANDING IS REQUIRED FOR YOU TO RENEW YOUR LIQUOR LICENSE. SINCE THESE

REQUESTS ARE PROCESSED ON A FIRST COME FIRST SERVED BASIS, FAILURE TO COMPLETE THE APPLICATION

PROPERLY COULD RESULT IN DELAYS WHICH ARE UNNECESSARY.

>>NOTE: ANY OUTSTANDING TAXES MUST BE PAID BY CERTIFIED CHECK, MONEY ORDER OR CASH PRIOR TO

ISSUANCE OF CERTIFICATE.

COMPLETE ALL OF THE FOLLOWING:

APPLICATION DATE: ____________________________________

FEDERAL ID ____________________________________

BUSINESS TYPE:

SOLE OWNER ______ CORPORATION _____ PARTNERSHIP ______ OTHER ________________

DO YOU HAVE EMPLOYEES? YES ________ NO _________

FEDERAL ID #: ___________________________________

DO YOU LEASE EMPLOYEES? YES _______ NO _________

NAME OF COMPANY _____________________________

SS NUMBER(S) OF OWNER / PARTNERS: _______________________ ___________________ _______________________

TELEPHONE NUMBER(S) : HOME _______________________________ BUSINESS ________________________________

PRINT NAME OF RESPONSIBLE PERSON ___________________________________________________________________

SIGNATURE OF RESPONSIBLE PERSON ____________________________________________________________________

OFFICE USE ONLY

SALES AND USE TAX DEL ________________________________________ A/R ______________________________________

(INCLUDING LOCAL MEAL/BEVERAGE)

WITHHOLDING TAX DEL _________________________________________A/R _______________________________________

PERSONAL INCOME TAX ________________________________________ A/R _______________________________________

CORPORATE TAX DEL. ___________________________________________ A/R ______________________________________

LITTER ___________ SALES RENEWAL ______________ CIG ____________ HOTEL ___________ RET CK______________

DET: ________________________________ REMARKS _____________________________________________________________

REVENUE OFFICER _______________________________________________________________ DATE ______________________

CLEARANCE AUTHORIZED BY: ____________________________________________________DATE: ______________________

Certificate Of Good Standing Application For A Liquor License Renewal Form