City Of Reading Business / Professional Registration Form

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CITY OF READING BUSINESS / PROFESSIONAL REGISTRATION FORM
City of Reading · Income Tax Office · 1000 Market Street · Reading, OH 45215-3283
Phone: (513) 733-0300 · FAX (513) 842-1016 ·
Account #: __________
ALL INFORMATION PROVIDED WILL REMAIN CONFIDENTIAL. RETURN COMPLETED FORM IN ENCLOSED ENVELOPE WITHIN 15 DAYS
Name of Business
______________________________________
Federal ID # / SS#
________________________________
Corporate Address
______________________________________
Corporate Phone #
_______________________________
______________________________________
Corporate Contact Person ________________________________
Doing Business As
______________________________________
E-Mail Address
________________________________
Reading Address
_________________________Suite #_______
Reading Phone #
________________________________
Nature of Business
______________________________________
Reading Contact Person
________________________________
Starting date of Reading Operation: ____________________________
Accounting Period
Calendar
Fiscal Year Ending ____ / ____
Type of Business: (please check one)
Sole Proprietorship
Partnership
S Corporation
Corporation
Ltd Liability Co
Non-Profit
Names of Corporate Officers (If applicable):
Number of employees at Reading Location:
President
__________________________________
Reported on W-2s:
__________________________
Treasurer
__________________________________
Number of contractual employee’s at Reading location:
Partners (If applicable):
Reported on 1099’s:
__________________________
Name
Address
Do you use a payroll company to submit monthly or quarterly
___________________________
_________________________
withholding payments? (Please check one)
Yes
No
___________________________
_________________________
If yes, list payroll company:
__________________________
Resident Businesses (businesses located in Reading):
Do you own the property where business is located? (Please check one)
Yes
No
If No, Please complete property owner information: Lessor Name:___________________________________________________________
Address of lessor: ____________________________________________________________________________________________________
Non-Resident Businesses (contractors, vendors, etc, temporarily conducting business in Reading):
Address of Reading job site: _______________________________________________________________________________________________
Please attach a complete listing with addresses and phone numbers of all subcontractors.
I do hereby certify that to the best of my knowledge the above information is true, correct and complete. Additionally, I understand that all
information contained herein is confidential.
_____________________________________________________________________________ _____________________
Title
Date
Signature

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