Sales And Use Tax Registration Application Form Page 2

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Louisiana Association of Tax Administrators
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or if unknown, please leave blank.
D. How many other locations in this Parish?
3.
Legal Name and Trade Name (?)
A. Legal name(s): Individual, partners, or corporation:
B. Trade name of business:
4.
Business Location Information (?)
A. Business location address (street, not PO Box):
B. City and State:
C. Zip:
D. Phone Number:
5.
Mailing Address Information (?)
My Mailing address is the same as my Location address
A. Address for receiving tax forms and correspondence:
B. City and State:
C. Zip:
6.
Contact Information (?)
A. Contact Person:
B. Contact Phone Number:
C. Fax Number:
D. Email Address:
E. Web Address:
F. Location of accounting records:
7.
Type of Organization (?)
Individual
Partnership
Corporation
LLC
LLP
Governmental
Non-Profit
Other
8.
If sole owner (individual): (?)
A. Name:
B. SSN:
C. Home address:
D. Phone number:
4/27/2012

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