Form Bls-700-028 - Master Application - State Of Washington Master License Service - 2000 Page 3
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43. Business Information (continued)
d.
Estimate gross annual income in Washington
(Please check one box that applies to your business. Estimate if needed.)
0 - $12,000
$12,001 - $28,000
$28,001 - $60,000
$60,001 - $100,000
$100,001 and above
e.
Please indicate the primary business activity you do in Washington (check only one):
Wholesale
Retail
Manufacturing
Services
f.
Describe in detail the principal products or services you provide in Washington. (Failure to provide this information will
cause delay in processing your application.)
g.
Did you buy, lease, or acquire all or part of an existing business?
No
All
Part
/
/
Date bought/leased/acquired:
Prior Business Name
MM
DD
YY
(
)
Telephone number
Prior Owner’s Name and address
h.
Did you purchase/lease any fixtures or equipment on which you have not paid sales or use tax?
Yes
No
If yes, indicate purchase or lease price: $
i.
If this business is owned by, controlled by, or affiliated with any other business entity, please indicate that business
entity’s name:
j.
If you are changing your business structure, (i.e., changing from sole proprietorship to corporation) and want the old
account closed, please indicate UBI number to be closed:
k.
If you ever owned another business, please provide:
Business Name
UBI Number
l.
If you currently own more than one Washington business/trade name, do you want a separate tax return for
each?
Yes
No
m.
List your bank name:
Do you plan to have employees or wish to register for optional coverage?
(Some LLC members are considered to be employees.
For further information on optional coverage definitions, see License Fee Sheet)
Yes
No
If NO
, skip to section 5.
If YES
, complete sections 4 and 5.
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BLS-700-028 MASTER BUSINESS APP. (R8/00) OR Page
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