KANSAS BUSINESS TAX APPLICATION
RCN
PART 1 –
REASON FOR APPLICATION
NOTE: If registered but adding another business
(mark one)
FOR OFFICE USE ONLY
location, you need only complete CR-17 (page 15).
Registering for additional tax type(s)
Started a new business
Purchased an existing business. Enter federal Employer ID Number (EIN) of previous owner: ________________________
See instructions on page 2 for important Tax Clearance information.
PART 2
– TAX TYPE
(check the box for each tax type or license requested and complete the required Parts of this application).
Retailers’ Sales Tax
Dry Cleaning Surcharge
Nonresident Contractor
(Complete Parts 1, 2, 3, 4, 5 & 12)
(Complete Parts 1, 2, 3, 4, 5 & 12)
(Complete Parts 1, 2, 3, 4, 5, 11 & 12)
Retailers’ Compensating Use Tax
Liquor Enforcement Tax
Water Protection/Clean Drinking Water Fee
(Complete Parts 1, 2, 3, 4, 5 & 12)
(Complete Parts 1, 2, 3, 4, 8 & 12)
(Complete Parts 1, 2, 3, 4, 5 & 12)
Consumers’ Compensating Use Tax
Liquor Drink Tax
(Complete Parts 1, 2, 3, 4, 5 & 12)
(Complete Parts 1, 2, 3, 4, 9 & 12)
IMPORTANT: Businesses are required
Withholding Tax
Cigarette Vending Machine Permit
to
electronically
file returns and/or
(Complete Parts 1, 2, 3, 4, 6 & 12)
(Complete Parts 1, 2, 3, 4, 10 & 12)
reports for
Kansas Retailers’ Sales,
Transient Guest Tax
Retail Cigarette/Electronic Cigarette License
Compensatin
g Use,
and
Withholding
(Complete Parts 1, 2, 3, 4, 5 & 12)
(Complete Parts 1, 2, 3, 4, 10 & 12)
taxes.
See the electronic file and pay
Tire Excise Tax
Corporate Income Tax
options available to you on
(Complete Parts 1, 2, 3, 4, 5 & 12)
(Complete Parts 1, 2, 3, 4, 7 & 12)
page 10, or visit our website
Vehicle Rental Excise Tax
Privilege Tax
at
.
(Complete Parts 1, 2, 3, 4, 5 & 12)
(Complete Parts 1, 2, 3, 4, 7 & 12)
PART 3
– BUSINESS INFORMATION
(please type or print).
1. Type of Ownership (check one):
Sole Proprietor
Limited Partnership
General Partnership
Limited Liability Partnership
Limited Liability Company
Federal Government
Other Government
Non-Profit Corporation
Other
Date of Incorporation _________________________________
State of Incorporation _____________________________
S Corporation
Date of Incorporation _________________________________
State of Incorporation _____________________________
C Corporation
2. Business Name: _________________________________________________________________________________________________________________
3. Business Mailing Address (include apartment, suite, or lot number): ________________________________________________________________
City _____________________________________________ County _______________________ State __________ Zip Code __________________
4. Business Phone: ________________________________________
Business Fax: _________________________________________
Email: ___________________________________________________________________
5. Business Contact Person: ________________________________________________________
Phone: ___________________________________
6. Federal Employer Identification Number (EIN): ______________________________________
(DO NOT enter Social Security number here)
7. Accounting Method (check one):
Cash Basis
Accrual Basis
8. Describe your primary (taxable) business activity: __________________________________________________________________________________
Enter business classification NAICS Code from Pub. KS-1500 (see instructions):____________________________________________________
9. Parent Company Name (if applicable): ____________________________________________________________________________________________
Parent Company EIN: ____________________________________
Parent Company Address (include apartment, suite, or lot number): ________________________________________________________________
City ____________________________________ County ___________________________________ State __________ Zip Code ___________________
10. Subsidiaries (if applicable).
If more than two, list them on a separate sheet and enclose it with this form.
Name: ____________________________________________________________________________________ EIN: ________________________________
Company Address (include apartment, suite, or lot number): _______________________________________________________________________
City ____________________________________ County ___________________________________ State __________ Zip Code ___________________
Name: ____________________________________________________________________________________ EIN: ________________________________
Company Address (include apartment, suite, or lot number): _______________________________________________________________________
City ____________________________________ County ___________________________________ State __________ Zip Code ___________________
11. Have you or any member of your firm previously held a Kansas tax registration number?
No
Yes
If yes, list previous number
or name of business: ______________________________________________________________
(Part 3 continues on next page)
FOR OFFICE
CR-16 (Rev. 3-17)
USE ONLY
11