Withholding And Business Registration Form - City Of Sowi Ncome Tax Division

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WITHHOLDING AND BUSINESS REGISTRATION
Income Tax Division
P O Box 1668
Stow, Ohio 44224
Phone: (330) 689-2849 Fax (330) 689-2847
Company Name
Phone #:
DBA:
Fax #:
Local business or job-site address
Mailing Address
(if different from above)
Initial date of business in Stow
Nature of business
Number of employees in Stow
Federal Identification #
NAICS #
**************************************************************************************
CHECK BUSINESS TYPE
Sole Proprietor
Corporation
Partnership
Limited Liability Co
S-Corporation
Non-Profit Corp
Estate or Trust
Other
For Corporation, list full name, address, social security #’s and phone #’s of each Officer
1)
2)
3)
For Partnership Entities, list full names, addresses and social security #’s and phone #’s of each partner
1)
2)
3)
For Sole Proprietor, list full name, address, social security # and phone #
Accounting period: Calendar Year
Fiscal Year
Month ending
Company’s Accountant, address and phone #
**************************************************************************************
PAYROLL INFORMATION
Will you be withholding employment taxes
Yes
No
Will the withholding be more than $200 per month
Yes
No
Will you only be withholding as a courtesy for a Stow resident
Yes
No
If courtesy withholding, please give name & SSN
Date withholding will begin
Do you presently use an outside payroll service
Yes
No
If yes, please provide name of payroll service
Do you lease employees from an employment agency
Yes
No
Full name, address and phone # of the person(s) or entity to whom your Stow location pays rents
**************************************************************************************
ABOVE INFORMATION IS REQUIRED
ALL INFORMATION IS CONFIDENTIAL

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