Business Questionnaire Form - Village Of New Concord Income Tax Department printable pdf download

Business Questionnaire Form - Village Of New Concord Income Tax Department

VILLAGE OF NEW CONCORD INCOME TAX DEPARTMENT

PO BOX 10

2 WEST MAIN STREET

NEW CONCORD OH 43762

Phone 740/826-7671

Fax 740/826-7617

BUSINESS QUESTIONNAIRE

NAME ______________________________________________________FED ID#__________________

ADDRESS ____________________________________________________________________________

CITY, STATE, ZIP _____________________________________________________________________

TO INSURE ACCURATE RECORDS, PLEASE ANSWER ALL QUESTIONS THAT PERTAIN

TO YOUR TAXABLE STATUS IN THE VILLAGE OF NEW CONCORD. PLEASE COMPLETE

AND RETURN WITHIN 10 DAYS. YOUR COOPERATION IS APPRECIATED.

Local name and address used for business purposes:

Trade Name-___________________________________ Location in New Concord_________________

IS THIS A COURTESY WITHHOLDING ACCOUNT FOR RESIDENT EMPLOYEES ONLY?

Yes or No (If so, list employee(s) name, address and social security number, sign, date and return

this form)

Do you employ any persons working within the Village of New Concord? ______ If yes, the number

Accounting period used for Income Tax purposes:

Calendar year ending Dec 31 ________

Check one- (If fiscal year, write ending date)

Fiscal year ending _________________

Type of ownership: (check which applies): Individual Proprietorship_____ Corporation_____

Partnership_____ Non-profit_____ Assoc_____ LLC_____ Other- explain_______________________

If partnership, assoc., or other unincorporated joint business venture, indicate how the net

profit Village Income Tax return will be filed and paid.

_____In full by the business or _____Separately by the individual members on proportionate

shares. List names and address of partners on back.

If individual proprietorship, indicate name, address and social security number of owner on

back.

If corporation, please indicate name, address and social security number of CEO on back.

With reference to real estate properties located WITHIN the Village of New Concord: Does the

business occupy, as tenant, real property in the Village of New Concord rented from others?____

If so, to whom is rent paid? (Give owners name and address).

(1)___________________________________________________________________________________

The information hereby submitted is true and correct.

Name ______________________________ Date ______________ Phone No. ______________________

(Signature)

Business Questionnaire Form - Village Of New Concord Income Tax Department