Form A-6 - Tax Clearance Application (2010) Page 2
Download a blank fillable Form A-6 - Tax Clearance Application (2010) in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form A-6 - Tax Clearance Application (2010) with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2APPLICANT’S NAME FROM PAGE 1
FORM A-6
(REV. 2010)
7.
CITY, COUNTY, OR STATE GOVERNMENT CONTRACT:
Bid/Entering Into or Ongoing Contract
Completion/Final Payment
For completion/final payment of contract, provide the name, agency, and telephone number of the contact person at the State or County Agency.
Name:
Agency:
Telephone Number:
8.
LIQUOR LICENSING:
Initial
Renewal
Transfer-Seller
Transfer-Buyer
Special Event
9.
CONTRACTOR LICENSING:
Initial
Renewal
10. STATE RESIDENCY:
DATE APPLICANT ARRIVED OR RETURNED TO HAWAII
11. ACCOUNTING PERIOD:
Calendar year
Fiscal year ending
(MM/DD)
12. TAX EXEMPT ORGANIZATION:
A) Provide the Internal Revenue Code Section that applies to your exemption (e.g., 501(c)(3)).
B) Does your organization file:
Federal Form 990, Return of Organization Exempt from Income Tax,
Federal Form 990-T, Exempt Organization Business Income Tax Return, or
None of the above.
13. INDIVIDUAL:
Spouse’s Name
SSN
14. IF YOU DO NOT HAVE A GENERAL EXCISE TAX LICENSE AND REQUIRE A TAX CLEARANCE FOR A GOVERNMENT CONTRACT:
A) Description of your firm’s business
B) Has your firm had any business income in Hawaii?
YES
NO
C) Has your firm had an office, inventory, property, employees, or other representatives in the State of Hawaii?
YES
NO
D) Has your firm provided any services within the State of Hawaii (e.g., servicing computers, training sessions, etc.)?
YES
NO
Note: If you answer “Yes” to any of the above questions, you are required to apply for a general excise tax license.
15. FILING THE APPLICATION FOR TAX CLEARANCE:
The completed application may be mailed, faxed, or submitted in person to the Department of Taxation, Taxpayer Services Branch. Applications which
require an Internal Revenue Service Tax Clearance will be forwarded to the Internal Revenue Service after processing is completed by the Department of
Taxation. Allow up to 10 to 15 business days for processing between the Department of Taxation and the Internal Revenue Service.
State Dept. of Taxation
Internal Revenue Service
TAXPAYER SERVICES BRANCH
WAGE & INVESTMENT DIVISION
P.O. BOX 259
-TC M/S H214
HONOLULU, HI 96809-0259
FIELD ASSISTANCE GROUP 562
TELEPHONE NO.: 808-587-4242
300 ALA MOANA BLVD., #50089
TOLL FREE: 1-800-222-3229
HONOLULU, HI 96850
FAX NO.: 808-587-1488
TELEPHONE NO.: 808-566-2748
or
FAX NO.: 808-524-5950
830 PUNCHBOWL STREET, RM 124
or
HONOLULU, HI
96813-5094
TAXPAYER ASSISTANCE CENTER
HONOLULU:
300 ALA MOANA BLVD., RM 1-128
Applications are available at Department of Taxation and IRS offices in Hawaii, and may also be requested by calling the Department of Taxation on Oahu
at 808-587-4242 or toll-free at 1-800-222-3229. The Tax Clearance Application, Form A-6, can be downloaded from the Department of Taxation’s website
( ).
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -FOR OFFICE USE ONLY - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Clerk’s
TYPE OF TAX
TAX RETURNS FILED STATUS
ITEMS RECEIVED
Initials
INCOME
GENERAL EXCISE/USE/
COUNTY SURCHARGE TAX
HAWAII WITHHOLDING
TRANSIENT ACCOMMODATIONS
RENTAL MOTOR/TOUR VEHICLE
UNEMPLOYMENT INSURANCE
OTHER TAXES
(Page 2 of 2)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial