Form St-75 - Sales And Use Tax Returns E-File Program - Enrollment Form And Certifications Page 3


ST-75 (7/01) Page 3 of 4
Paid preparer enrollment
Preparer’s firm name
Employer identification number
(or yours, if self-employed)
Preparer’s SSN or PTIN
Mailing address
(number and street or PO Box)
City, State, ZIP code
Paid preparer certification
I, the undersigned, am a paid preparer of sales and use tax returns for
(legal name
of taxpayer as it appears on Certificate of Authority), located at
(business address),
with sales tax identification number
(the taxpayer).
I understand and agree that by virtue of my signature on this enrollment form, each and every return filed by me/my business
on behalf of the taxpayer under the sales and use tax e-file program for filers of Forms ST-100 and ST-102 shall be deemed
to have been signed by me, that my deemed signature on such return shall constitute a certification by me that such return is
true, accurate, and complete, and that each such return shall be treated as the legal equivalent of a signed paper return. (The
declaration of the paid preparer is based on all information of which the preparer has any knowledge.)
I certify that I have examined this application and any accompanying information, and to the best of my knowledge and belief it is
true, correct, and complete.
If the paid preparer named above is other than an individual: I certify that I am acting in the capacity of a corporate officer,
partner (except a limited partner), member, or manager of a limited liability company, and that I have the authority to execute this
Paid preparer certification on behalf of the preparer.
Paid preparer’s signature
Printed name (affix corporate seal, if applicable)
Name of contact representative
Business telephone number
Fax number
Internet email address


00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Page of 4