Form 78-005 - Iowa Business Tax Registration 2000
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2I O WA
Iowa Business Tax Registration Form
d e p a r t m e n t o f R e v e n u e a n d F i n a n c e
If you are applying for more than one type of tax permit and the mailing addresses or responsible parties are
different, attach a separate sheet listing the appropriate information. It may take up to six weeks before you
PLEASE TYPE OR PRINT LEGIBLY
receive your permit; however, you are allowed to conduct business as soon as you submit your application.
I. LOCATION NAME/ADDRESS
II. MAILING NAME/ADDRESS
If your mailing address is different than the location of your business,
complete this section.
IV. TYPE OF OWNERSHIP (check one)
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Telephone Number Required
Date Established: _____________________________________
III. PREVIOUS OWNER
If you are purchasing this business, provide previous owner’s name:
________________________________________________________
V. RETAILER REGISTRATION
q
Calendar quarters in which business is operated:
CONSUMER’S USE TAX (no fee):
This is only for those who
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q
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purchase taxable goods or services for use in Iowa and do not pay
Entire year
Jan.-March
April-June
sales tax when the purchases are made.
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July-Sept.
Oct.-Dec.
Starting date
Type of products or services to be sold: _________________
How much consumer’s use tax do you think you will owe?
q
q
hotel motel inn
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bed and breakfast
q
OUT-OF-STATE RETAILER’S USE TAX PERMIT (no fee):
Retailers making taxable sales in Iowa from an out-of-state location
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SALES TAX PERMIT (no fee)
must register to collect use tax.
Starting date
Starting date
How much tax do you expect to collect?
q
What is the method of payment?
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check _____ or EFT ____
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q
check _____ or EFT ____
q
HOUSEHOLD HAZARDOUS MATERIAL PERMIT:
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check _____ or EFT ____
Starting date
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q
q
VI. WITHHOLDING TAX REGISTRATION (no fee)
Complete this section if you have employees.
Starting date
What is the payment method?
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check ___ or EFT ___
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q
AUTOMOBILE RENTAL TAX (no fee)
check ___ or EFT ___
q
If you rent motor vehicles to customers, you must collect this tax. All
(EFT required)
automobile rental permit holders file quarterly.
Starting date
Withholding Agent’s Name: __________________________________________
Social Security Number: ____________________________________________
Address: ____________________________________________
78-005 (6/16/00)
City, State, Zip: ____________________________________________
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