Form 78-005 - Iowa Business Tax Registration 2000 (Page 2 of 2) in pdf

VII. CORPORATION/PARTNERSHIP REGISTRATION

INFORMATION

Complete this section only if you are registering to file corporation or

partnership income tax returns.

Starting date

Section I: Location Name/Address

Regular

S Corp

UBIT

Coop

IC-DISC

FSC

Section V: Retailer Registration

Consolidated Returns:

VIII. OWNERS, GENERAL PARTNERS, CORPORATE

Electronic Funds Transfer (EFT):

OFFICERS AND RESPONSIBLE PARTIES

Household Hazardous Material Permit

Name: _____________________________________________

SSN: ______________________________________________

IX. SIGNATURE

Section VI: Withholding Tax – Withholding Agent

FOR OFFICE USE ONLY

Mailing Address/Fax Number

COUNTY: _________________________________________________________

PERMIT NUMBER

FILER TYPE

_________________________________________________________________

IOWA COUNTIES AND COUNTY NUMBERS

_________________________________________________________________

01-ADAIR

26-DAVIS

51-JEFFERSON

76-POCAHONTAS

02-ADAMS

27-DECATUR

52-JOHNSON

77-POLK

03-ALLAMAKEE

28-DELAWARE

53-JONES

78-POTTAWATTAMIE

BUS CLASS: ______________________ OWNER TYPE: ___________________

04-APPANOOSE

29-DES MOINES

54-KEOKUK

79-POWESHIEK

05-AUDUBON

30-DICKINSON

55-KOSSUTH

80-RINGGOLD

HOTEL/MOTEL: ________________

06-BENTON

31-DUBUQUE

56-LEE

81-SAC

07-BLACK HAWK

32-EMMET

57-LINN

82-SCOTT

08-BOONE

33-FAYETTE

58-LOUISA

83-SHELBY

FOR ASSISTANCE...

09-BREMER

34-FLOYD

59-LUCAS

84-SIOUX

10-BUCHANAN

35-FRANKLIN

60-LYON

85-STORY

Visit our Website at

11-BUENA VISTA

36-FREMONT

61-MADISON

86-TAMA

12-BUTLER

37-GREENE

62-MAHASKA

87-TAYLOR

or call 1-800-367-3388

13-CALHOUN

38-GRUNDY

63-MARION

88-UNION

14-CARROLL

39-GUTHRIE

64-MARSHALL

89-VAN BUREN

(Iowa and Omaha and Rock Island/Moline)

15-CASS

40-HAMILTON

65-MILLS

90-WAPELLO

16-CEDAR

41-HANCOCK

66-MITCHELL

91-WARREN

515/281-3114 (local and out of state)

17-CERRO GORDO

42-HARDIN

67-MONONA

92-WASHINGTON

18-CHEROKEE

43-HARRISON

68-MONROE

93-WAYNE

19-CHICKASAW

44-HENRY

69-MONTGOMERY

94-WEBSTER

INCOMPLETE APPLICATIONS

20-CLARKE

45-HOWARD

70-MUSCATINE

95-WINNEBAGO

21-CLAY

46-HUMBOLDT

71-O’BRIEN

96-WINNESHIEK

WILL DELAY PROCESSING.

22-CLAYTON

47-IDA

72-OSCEOLA

97-WOODBURY

23-CLINTON

48-IOWA

73-PAGE

98-WORTH

24-CRAWFORD

49-JACKSON

74-PALO ALTO

99-WRIGHT

78-005b (6/16/)

25-DALLAS

50-JASPER

75-PLYMOUTH

Form 78-005 - Iowa Business Tax Registration 2000 Page 2

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