Questionnaire Municipal Income Tax - City Of Piqua, Ohio

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QUESTIONNAIRE
MUNICIPAL INCOME TAX – CITY OF PIQUA, OHIO
The following information will aid us in preparing forms for your use under the Piqua Income Tax Ordinance.
Please answer questions fully and return this questionnaire to the Department of Taxation, 1 Aerovent Drive,
Piqua, Ohio. Your compliance with this request within five days will be greatly appreciated.
1.
Please check your type of business:
Individual Proprietorship___ Corporation____ Partnership_____ Non-Profit Organization_____
Association____ Other______ Federal Identification No._________________
2.
Give home address of owner(s) or all partners if a partnership exists:
Name
Address
Telephone
(a)_________________________________________________________________________________
(b)_________________________________________________________________________________
(c)_________________________________________________________________________________
3.
Name of corporation___________________________________________________________________
Business telephone____________________________________________________________________
(a) Name of officer to whom forms should be sent___________________________________________
4.
Business address_____________________________________________________________________
5.
Mailing address_______________________________________________________________________
6.
Trade name (if any)____________________________________________________________________
7.
Are there now, or will there be employees subject to City of Piqua Income Tax?
Yes_____
No______
Approximate Number____________
8.
Date business activities started in Piqua____________________________________________________
1.
Nature of business ____________________________________________________________________
2.
Accounting Period: Calendar Year ______ Fiscal Year Ending _______
3.
Do you Own______ Rent_______ Lease______ your place of business in Piqua?
If you rent or lease, from whom?
Name_______________________________________________________________________________
Address_____________________________________________________________________________
4.
Name and address of person or organization in charge of books or records:
Name_______________________________________________________________________________
Address_____________________________________________________________________________
Thank you for your cooperation.
Department of Taxation
1 Aerovent Drive, P.O. Box 1223
Piqua, OH 45356
Telephone # (937) 778-2009
FAX # (937) 778-1130

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