Form 10a104 - Update Or Cancellation Of Kentucky Tax Account(S) - 2017 Page 2
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410A104 (06-17)
Page 2
SECTION D
SALES AND USE TAX LOCATION INFORMATION
11. Update or Close an existing Business Location for your Sales and Use Tax Account.
CURRENT LOCATION ADDRESS INFORMATION
NEW LOCATION ADDRESS INFORMATION
Close Location
Update/Move Location
Business Location Name “Doing Business as” Name
Business Location Name “Doing Business as” Name
Street Address (DO NOT List a PO Box)
Street Address (DO NOT List a PO Box)
City
State
Zip Code
City
State
Zip Code
County (if in Kentucky)
Location Telephone Number
County (if in Kentucky)
Location Telephone Number
(
)
–
(
)
–
Date Location Closed (mm/dd/yyyy)
/
/
12. - 13. Opened a new Location(s) of Current Business
NEW LOCATION ADDRESS
NEW LOCATION ADDRESS
Business Location Name “Doing Business as” Name
Business Location Name “Doing Business as” Name
Street Address (DO NOT List a PO Box)
Street Address (DO NOT List a PO Box)
City
State
Zip Code
City
State
Zip Code
County (if in Kentucky)
Telephone Number
County (if in Kentucky)
Telephone Number
(
)
–
(
)
–
Date Location Opened (mm/dd/yyyy)
Date Location Opened (mm/dd/yyyy)
/
/
/
/
Description of Business Activity Performed at Location
Description of Business Activity Performed at Location
SECTION E
UPDATE ACCOUNTING PERIOD, OWNERSHIP TYPE, AND/OR RESPONSIBLE PARTIES
14. Accounting Period change with the Internal Revenue Service (IRS)
Accounting Period
Calendar Year (year ending December 31
)
Fiscal Year (year ending ___ ___/___ ___ (mm/dd))
st
52/53 Week Calendar Year:
52/53 Week Fiscal Year:
December __________________________
__________________________________________
(Day of Week that year ends)
(Month & Day of Week that year ends)
15. Taxing Election Change with the IRS
(Note: If your Business Structure has changed, you are required to apply for new tax account numbers with the Department of
Revenue. Please complete Form 10A100, Kentucky Tax Registration Application.)
A. Current Business Structure ____________________________________________________________________
B. CURRENT TAXING ELECTION
NEW TAXING ELECTION
Partnership
Partnership
Corporation
Corporation
S-Corporation
S-Corporation
Cooperative
Cooperative
Trust
Trust
Single Member Disregarded Entity
Single Member Disregarded Entity
(Member Federally Taxed as)
(Member Federally Taxed as)
Individual Sole Proprietorship
Individual Sole Proprietorship
General Partnership/Joint Venture
General Partnership/Joint Venture
Estate
Estate
Trust (non-statutory)/Business Trust
Trust (non-statutory)/Business Trust
Other ______________________________________
Other ______________________________________
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Parent category: Financial