Form 78-005b - Iowa Business Tax Registration - Iowa Department Of Revenue printable pdf download

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Iowa Department of Revenue

Iowa Business Tax Registration

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If you are applying for more than one type of tax permit and the mailing addresses or responsible parties are

different, attach a separate sheet listing the appropriate information. It may take up to six weeks before you receive

Please Type or Print Legibly

your permit number; however, you are allowed to conduct business as soon as you submit your application. Incomplete

applications will delay processing.

I. PHYSICAL LOCATION NAME / ADDRESS

II. MAILING ADDRESS

Federal Employer ID Number: _____________________________

Complete if different from physical location.

Social Security Number: _________________________________

Name: _______________________________________________

Legal Name: (sole proprietors: fill in last name, first name)

Mailing Address: _______________________________________

City: _____________________ State: ____ Zip+4: ___________

Trade Name: (doing business as), if you have one

Phone 1: ___________________________ Ext. _______

Phone 2: ___________________________ Ext. _______

Street Address (Not PO Box): ____________________________

E-mail Address: ____________________________________

City: _____________________ State: ____ Zip+4: ___________

IV. TYPE OF OWNERSHIP (MUST check one)

County Name: _____________________ County Number: _____



Sole Proprietor

Partnership

Corporation

Daytime Phone: ______________________ Ext. _______







Association

Government

Phone 2: ___________________________ Ext. _______

Limited Liability Company (LLC):

Fax Number:



LLC Single member filing on owner’s income tax return

Telephone Number Required



LLC Filing as partnership



LLC Filing as corporation

III. PREVIOUS OWNER

Date Established: _____________________________________

If purchasing an existing business, provide former owner’s name:

State in which Established: _______________________________

V. RETAILER REGISTRATION

Calendar quarters in which business is operated:

    

OUT-OF-STATE RETAILER’S USE TAX PERMIT (no fee):

Retailers making taxable sales in Iowa from an out-of-state location





Entire year

Jan.-March

April-June

must register to collect retailer’s use tax.



July-Sept.

Oct.-Dec.

Starting date for selling at retail in Iowa:

(MM/DD/YY) ___________

Type of products or services to be sold: ____________________

How much tax do you expect to collect?

______________________________________________________



less than $120 tax/year (file Annually)



Check this box if your business is a hotel, motel, inn,



less than $1,500 tax/month (file Quarterly)

bed and breakfast, or cabin with sleeping quarters.



more than $1,500 tax/month (file Monthly)

    

SALES TAX PERMIT (no fee):

    

AUTOMOBILE RENTAL TAX (no fee):

Starting date for selling at retail:

(MM/DD/YY) __________________

If you rent automobiles to customers, you must collect this tax.

How much sales tax do you expect to collect?

Automobile rental tax is always filed quarterly.



less than $120 tax/year (file Annually)

Starting date for renting automobiles in Iowa:

(MM/DD/YY) ______



less than $500 tax/month (file Quarterly)

    

HOUSEHOLD HAZARDOUS MATERIAL PERMIT:



more than $500 tax/month (file Monthly)

See “INFORMATION” section for explanation of HHM permits.



more than $5,000 tax/month (electronic payment required)

Starting date for selling hazardous material:

(MM/DD/YY) _______

(file Semi-monthly)





Regular ($25 fee)

Special ($125 fee or more)

If you have more than one location, do you want to file

When you pay by check, your authorize the Department to convert

consolidated returns? __________________________________

your check to a one-time electronic banking transaction.

Number of locations to file consolidated: ____________________

VI. WITHHOLDING TAX REGISTRATION (no fee)

See “INFORMATION” section on consolidated returns.

Complete this section if you have employees.

    

CONSUMER’S USE TAX (no fee):

Starting date for withholding Iowa income tax: _____________

This is only for those who purchase taxable goods or services

(MM/DD/YY)

consumed in Iowa on which sales tax is not paid when the

How much Iowa income tax do you think you will be withholding?

purchases are made.



less than $500 tax/month (file Quarterly)



Starting date for making purchases:

more than $500 tax/month (file Monthly)

(MM/DD/YY) _______________

How much consumer’s use tax do you think you will owe?



more than $10,000 tax/month (file Semi-monthly)

(electronic payment required)



less than $120 tax/year (file Annually)



See “INFORMATION” section for definition of withholding agent.

more than $120 tax/year (file Quarterly)

Withholding Agent’s Name: ________________________________

Social Security Number: ___________________________________

Address: _______________________________________________

City, State, Zip: _________________________________________

Form 78-005b - Iowa Business Tax Registration - Iowa Department Of Revenue

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