Soft Drink And Syrup Tax Application Form

ADVERTISEMENT

MAINE REVENUE SERVICES
SOFT DRINK and SYRUP TAX
APPLICATION
1. BUSINESS INFORMATION:
Email address
Legal Name
Business Trade Name
Social Security Number
Business Phone Number
Federal Employer ID No. (EIN)
Physical Location of Business
Primary Mailing Address
2. TYPE OF OWNERSHIP (check appropriate box):
Sole Proprietor
Partnership*
Estate*
Association*
C Corporation (Regular)*
Limited Partnership*
Trust*
Other*
S Corporation (Sub “S”)*.
Limited Liability Company*/**
Non Profit Organization (501(c)(3))*
Corporation (Non Profit )*
(attach copy of IRS exemption letter)
* Federal Employer Identification Number (EIN) required above
** Form 8832 required, if filed with IRS - check one
corporation
sole proprietor
partnership
If you marked “Other”, please explain type of ownership
Corporations — Date Incorporated
State of Incorporation
Limited Partnerships — Date Registered
State of Registration
Limited Liability Co.’s — Date Registered
State of Registration
3. REQUIRED OWNER INFORMATION (Names of directors, partners, officers or members; name of trustee or personal representative; name of
responsible party):
Name & Title
Name & Title
Social Security Number (REQUIRED)
Social Security Number (REQUIRED)
% of Business Owned
Home Phone
% of Business Owned
Home Phone
Home Address
Home Address
4. TYPE OF BUSINESS
Check the type that applies to your business.
Distributor
Manufacturer
Wholesaler
Retailer
5. SOFT DRINK & SYRUP TAX ACCOUNT ADDRESS FOR RETURNS AND NOTICES: Check if same as primary mailing address above:
Address:
Email:
Attention:
Telephone:
I certify that the information contained in each section of this application is true, correct and complete to the best of my knowledge and belief.
This application must be signed by an owner, director, partner, member, officer, trustee or personal representative, or responsible party.
SIGNATURE
TITLE
DATE
TELEPHONE NUMBER
Please print or type your name
Mail to:
Maine Department of Labor
Central Registration Section
PO Box 1057
Augusta, ME 04332-1057
Central Registration - Fax # 207 287-3733 Phone # 207 621-5129

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2