Form Ar4er - Withholding Registration
ADVERTISEMENT
1State of Arkansas
DEPARTMENT OF FINANCE AND ADMINISTRATION
Withholding Registration
AR4ER
P. O. Box 8055 Little Rock, Arkansas 72203-8055
(Please read Instructions on reverse side. Please type or print. Keep one copy)
ALL NEW ACCOUNTS FILE ON A MONTHLY BASIS - THERE IS NO QUARTERLY FILING.
01.
Employer’s
Federal
--
___ ___
___ ___ ___ ___ ___ ___ ___
Identification Number:
2.
Name of
Business:
(
)
_____________________________
(Trade Name)
Phone #
3.
Business
Location Address:
_________________________________________________________________________________________________________________________
Street
(Physical Location)
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
City
State
Zip
4.
Mailing or
Care of Address:
_________________________________________________________________________________________________________________________
In Care Of
_________________________________________________________________________________________________________________________
Street
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
City
State
Zip
5.
Name of Owner or
Responsible Party:
a.
c.
(
)
_____________________________
Phone #
--
--
Social Security Number:
b.
___ ___ ___
___ ___
___ ___ ___ ___
6.
Owner/Responsible
Party Address:
________________________________________________________________________
Street
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
City
State
Zip
7.
Date Arkansas Withholding
was started and/or required
_________________________________________
Month / Day / Year
8.
Principal Business
Activity:
9.
Type Organization:
1. Ind. Owner
2. Part.
3. D. Corp.
4. F. Corp.
10.
County - Arkansas:
Signature of Owner
or Responsible
________________________________________________________________________
Signature
Party:
______________________
Date
11.
Federal Business Code:
Dept. Use only
12.Examiner Code __________________
AR4ER (R 9/99)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial