Form Fr-500t - Combined Business Tax Registration Application
ADVERTISEMENT
1
2---
---
-
~--
FR-500T
COMBINED BUSINESS TAX
I
GOVERNMENT OFTHE DISTRICTOF COLUMBIA
REGISTRATION APPLICATION
-
OFFICE OF TAX AND REVENUE
TAXICAB
AND LIMOUSINE SUPPLEMENTAL
INFORMATION
FORM
....PA"f .I-.GENERAL
INFORMATION
D
485310
(Taxi
Service)
D 485320 (Limousine Service)
(1.) Federal Employer Identification Number
(2.) NAICSBusiness Code (select one)
(3.) Social Security or Other Identifying Number
(4.) Last Name
(5.) First Name
(6.) Middle Initial
(7.) Mailing Address - Number and Street
(8.) Apartment Number
(9.) Daytime Phone
(10.) Evening Phone
(11.) Alternate Phone
PART II - QUESTIONNAIRE
(1.) Please select one of the following:
_
I am a taxicabI limousinedriver,and I OWNthe vehiclethat I utilizefor theseservices.
_
I am a taxicabI limousinedriver,and I LEASEthe vehiclethat I utilizefor theseservices.
_
I ownone or moretaxicab(s)Ilimousine(s),but I AM NOTA DRIVER.
(2.) From whom do you lease your vehicle (lessor information)?
(2a.) Name
(2b.) Address
(2c.) TelephoneNumber
(3.) How is your lease calculated? (Please select one of the following):
Daily_
Weekly _
Monthly _
Semi-Annually _
Annually _
Other (calculated by mileage,etc.)
(4.) To what individual or business are your insurance payments made? Please provide the following information:
(4a.) Name of Business or Individual
(4b.) PhoneNumber
(4c.) Street address, city, state and zip code
(5.) How often do you make insurance payments? (Please select one of the following):
Daily_
Weekly
_
Monthly
_
Semi-Annually
_
Annually _
Other
(6.) In what state is your taxicab I limousine titled?
Title#:
Signature
Date
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial