Form 980 - Dealer In Intangibles Tax Return - 2001
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32001
Dealer in Intangibles Tax Return
Form 980
Rev. 9/00
c
c
Single County
Inter-County
Account Number
Received Stamp
Ohio Charter Number
Federal Employer Identification Number
Social Security Number
Time Extension Permit
c
c
Type of Business:
c
c
April 13, 2001
Ten Dollars ($10)
$ _____________
$ _____________
Do Not Send Check with this Tax Return. You will be Billed.
$ _____________
$ _____________
Pre-
Data
receive
Assessment
Entry
March 12, 2001
Verification
Verification
Declaration
Person, other than taxpayer, preparing this return
Date
Signature of Taxpayer
Title
Date
Address
Print Name of Taxpayer
Date
(
)
-
(
)
-
Phone Number
Phone Number
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Parent category: Financial