Sales And Use Tax Registration Application Form

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St. John the Baptist Parish
OFFICIAL USE ONLY
*Enter Information in
Sales
Use Tax Registration Application
Boxes Only
and
ACCOUNT NUMBER:
1. Reason for Applying:
A. Started new business
D. Merger*
ISSUER:
DATE:
B. Purchased existing business*
E. Change of name*
C. Opening additional location*
F. Other, explain >>
*Name of previous business:
*Previous account number:
Applied for
None
2.
Louisiana Sales Tax Number:
Applied for
None
Federal Identification Number:
Legal Name of business:
3.
Trade Name of business:
Business Location:
4.
Physical Address
City
State
Zip code
Phone
Parish
Mailing Address:
5.
(If same as 4. write "same")
Mailing Address
City
State
Zip code
Phone
Parish
Contact Person:
6.
Contact Phone:
Fax:
E-Mail Address:
Web Site:
Location of Accounting Records:
Physical Address
City
State
Zip code
Phone
7.
Type of Organization:
Individual
Corporation
LLC
Non-Profit
Partnership
LLP
Government
Other type >
8. If Sole Owner, Individual:
Full Name
Social Security #
Phone #
Home Address
City
State
Zip code
9. If Corporation, Partnership, LLC, LLP or Other:
list name, title, SSN, home address and phone # of principals
Full Name
Title
Social Security #
Phone #
Home Address
City
State
Zip code
Full Name
Title
Social Security #
Phone #
Home Address
City
State
Zip code
Agent for service of process:
10.
Full Name
Physical Address
City
State
Zip code
Phone
11. First date sales will be made:
Date business started operations:
12. Nature of Business:
Retail
Wholesale
Service
Manufacturing
Contractor
Other
Describe in detail the nature of your business:
13. Reporting status
:
Monthly
Quarterly
Semi-Annual
Annual
Occasional/Irregular
(official use)
14. Where will your transactions occur?
Parish Wide
State Wide
Other >
I affirm that the information given on this application is complete, true and correct.
Signature of Applicant:
Title:
Signature of Preparer:
Date:

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