Form Bb-1 - Basic Business Application
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02
FORM BB-1
This Space For Office Use Only
STATE OF HAWAII
(Rev. 2004)
BASIC BUSINESS APPLICATION
TYPE OR PRINT LEGIBLY
Identification number
1. Type of application (Check the appropriate box(es) that best describes your purpose in filing this application)
W __ __ __ __ __ __ __ __ - __ __
o General Excise
o Use Tax Only
o Seller's Collection
o Transient Accommodations
o Employer's Withholding o GE One Time Event
UI Registration Number
o Rental Motor Vehicle & Tour Vehicle
o Cigarette and Tobacco
o Liquor
o Unemployment Insurance
o Liquid Fuel Distributor
o Liquid Fuel Retail Dealer
2. Taxpayer's/Employer's Name (Individuals, enter Last, First, Middle Initial)
3. Doing business as (DBA) name
5. Type of ownership o Sole proprietorship o Corporation (See Instructions)
o Other (Explain)
4. FEIN
o Partnership
o Federal Agency
6. Date Business Began in Hawaii
7. Date of Incorporation (MM/DD/YYYY)
8. Incorporation State
9. Accounting period, check only 1
10. Accounting method, check only 1
11. NAICS (See Instructions)
o Calendar Year
o Cash
o Accrual
__ __ __ __ __ __
o Fiscal Year ending (
)
/
MM/DD
12. Mailing address
C/O
Street address or P.O. Box
City
State
Zip Code + 4
13. Physical location of business in Hawaii
Street address
City
State
Zip Code + 4
14. If no physical business location in Hawaii, provide the name, address, and telephone number of the individual performing services in Hawaii
15. Phone Number
Business
Residential
Fax
E-mail address
(
)
(
)
(
)
o Yes
o No
16. Does all or part of this business qualify for a disability exemption?
( See Instructions )
17. Name of Parent Corporation
18. Parent Corp.'s FEIN
19. Parent Corporation's Mailing Address
20. List all the owners (including sole proprietors), partners, members, or corporate officers ( See Instructions on back of the form ) Attach a separate sheet of paper if more space is required.
SSN
Name (Last, First, Middle Initial)
Title
Residential Address
Contact Phone No.
(
)
(
)
21. (a) Did you acquire an existing business? o Yes o No
22. No. of establishments or branches in Hawaii
23. Date employment began in Hawaii
(b) If yes, was o all or o part of the business acquired?
/
/
(c) When was it acquired? ____________________
24. No. of employees on date employment began
25. Date first wages paid in Hawaii
(MM/DD/YYYY)
(d) Previous owner's/business' name, dba, address, Hawaii Tax I.D. No.,
/
/
and UI Account No. (If you answered "No" to (a) enter N/A)
26. If no employees, when do you anticipate hiring employees?
/
/
27. If you are applying for a TA Tax, Liquid Fuel Retail Dealer Permit, and/or RVST Tax I.D. number(s), attach a list of (1) the address(es) of the business
locations, (2) island, and (3) note the location's activity as either TA, Fuel, or RVST.
.
28. (a) How many TA units are you registering for?
31
Enter the amount from line i. of the registration fee worksheet on the
o 1-5 units
o 6 or more units
back of the form here and on the Total Payment line for
$
(b) Date TA activity began in Hawaii
Form VP-1, Tax Payment Voucher. Attach Form VP-1 to this form.
/
/
32.
Enter the amount from line n. of the registration fee worksheet on the
29. Date RVST activity began in Hawaii
back of the form here and on the Total Payment line for Form VP-2,
$
/
/
Miscellaneous Fee Payment Voucher. Attach Form VP-2 to this form.
TOTAL REGISTRATION FEE DUE
30. Filing period, Check 1 box for each tax type applicable
Add lines 31 and 32. Attach
33.
Tax Type
Mo
Qtr
Semi
a check or money order made payable to "HAWAII STATE TAX
o
o
o
$
a) GE
COLLECTOR" in U.S. dollars drawn on any U. S. Bank ················
o
o
o
b) TA
o
o
o
c) RVST
CERTIFICATION: The above statements are hereby certified to be correct to the best of
o
o
d) WH
knowledge and belief of the undersigned who is duly authorized to sign this application.
Mail the completed application to:
HAWAII DEPARTMENT OF TAXATION
Signature of Owner, Partner or Member, Officer or Agent
P.O. Box 1425
Honolulu, HI 96806-1425
Print Name
Title
Date
02
FORM BB-1
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