Form Wbq - Questionnaire - City Of Greenville
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1CITY OF GREENVILLE, OHIO
INCOME TAX DEPARTMENT
Municipal Building
100 Public Square
Greenville OH 45331-1499
PHONE: 937-548-5747; FAX 937-548-3035
QUESTIONNAIRE
(FORM WBQ)
1. Name of Individual
or
Owner(s)
2. Name of Corporation
(a) Statutory Agent
SSN
(b) Federal Identification Number
(c) Telephone Number
Fax Number
3. Trade Name (If any)
4. Give home address of Owner(s) or all Partners if a Partnership & include social security number(s)
NAME
ADDRESS
TELEPHONE
SSN
(a)
(b)
(c)
5. Business Address
6. Mailing Address (If different from above)
7. Date when business (or job) started or will start in Greenville
8. If you are a Non-Resident Contractor, approx. number of days you will be on job
9. How many Employees will you have? (Do not include yourself)
10. Type of Organization: Individual
Partnership
Corporation
11. Accounting Period: Calendar Year
*Fiscal Year Ending
12. Nature of Business
13. With reference to Real Estate Property and Personal Property within the City of Greenville:
(a) Does the Business or Profession occupy, as Tenant, Real Property rented from others?
Yes
No
If yes, to whom is rent paid
name
address
(b) Does the Business or Profession rent or lease Furniture, Fixtures, Equipment of any kind or
Machinery from others? Yes
No
If yes, to whom is rent paid?
NAME
ADDRESS
14. Do you desire to remit Withholding Monthly
Quarterly
15. Do you have a payroll service? Yes
No
If yes, indicate name of service
16. Do you have any sub-contractors on the Greenville job? Yes
No
If yes, please attach list.
17. Signature
Date
*NOTE: A fiscal year ending can only be used when your accounting period as used on Federal Return
does not end on December 31.
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