Form Gew-Ta-Rv-5 - General Excise/use, Employer'S Withholding, Transient Accommodations And Rental Motor Vehicle, Tour Vehicle & Car-Sharing Vehicle Surcharge Application Changes
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STATE OF HAWAII
FORM GEW-TA-RV-5
DO NOT WRITE IN THIS AREA
03
(REV. 2014)
DEPARTMENT OF TAXATION
GENERAL EXCISE/USE, EMPLOYER’S
WITHHOLDING, TRANSIENT ACCOMMODATIONS
AND RENTAL MOTOR VEHICLE, TOUR VEHICLE &
CAR-SHARING VEHICLE SURCHARGE
APPLICATION CHANGES
IMPORTANT: File this form ONLY if there are changes to your license application (Form BB-1).
Name:
Hawaii Tax I.D. No.:
W __ __ __ __ __ __ __ __ -__ __
PLEASE CHANGE MY:
1b. Reason for Name Change:
1a.
Name to:
(Attach documentation of name change, such as marriage certificate, DCCA filing, etc.)
(NOTE: If a new FEIN is required, a new license must be obtained.)
2.
Trade Name or Doing Business As (DBA) Name to:
3a.
Business Phone Number to:
3b.
Residential Phone Number
(
)
(
)
to:
4.
E-mail Address to:
5.
Primary NAICS Code to:
__ __ __ __ __ __
__ __ / __ __
6.
Accounting Period to:
Calendar Year
Fiscal Year Ending
As of:
.
7.
Accounting Method to:
Accrual
Cash As of:
.
From:
To:
8.
General Excise Filing Period for:
Monthly
Monthly (Annual tax exceeds $4,000.)
Hawaii Tax I.D. No. W __ __ __ __ __ __ __ __ - __ __
Quarterly
Quarterly (Annual tax does not exceed $4,000.)
As of
*
Semi-annually
Semi-annually (Annual tax not more than $2,000.)
From:
To:
9.
Withholding Filing Period for:
Monthly
Monthly (Annual tax exceeds $5,000.)
Hawaii Tax I.D. No. W __ __ __ __ __ __ __ __ - __ __
Quarterly
Quarterly (Annual tax does not exceed $5,000.)
As of
*
From:
To:
10.
Transient Accommodations Filing Period for:
Monthly
Monthly (Annual tax exceeds $4,000.)
Hawaii Tax I.D. No. W __ __ __ __ __ __ __ __ - __ __
Quarterly
Quarterly (Annual tax does not exceed $4,000.)
As of
*
Semi-annually
Semi-annually (Annual tax not more than $2,000.)
From:
To:
11.
Rental Motor Vehicle, Tour Vehicle & Car-Sharing Vehicle
Monthly
Monthly (Annual tax exceeds $4,000.)
Filing Period for:
Quarterly
Quarterly (Annual tax does not exceed $4,000.)
Hawaii Tax I.D. No. W __ __ __ __ __ __ __ __ - __ __
Semi-annually
Semi-annually (Annual tax not more than $2,000.)
As of
*
* NOTE: The requested change will take effect after the current filing period is over. The filing frequency cannot be changed retroactively.
PLEASE ADD:
12.
Federal Employer I.D. No.
(NOTE: If your FEIN has changed, you must apply for a new license. This line is ONLY for those applicants
__ __ -__ __ __ __ __ __ __
who did not have a FEIN at the time the original application was filed.)
Hawaii Tax I.D. No.
13.
Parent Corporation’s: FEIN
14.
Trade Name or Doing Business As (DBA) Name:
__ __ -__ __ __ __ __ __ __
W __ __ __ __ __ __ __ __ - __ __
15.
New Partners, Members, or Corporate Officers (List on page 2 of
16.
Address(es) for my Rental Real Property, Rental Motor Vehicle,
this form.)
Tour Vehicle and/or Car-Sharing Vehicle Business, and Transient
Accommodations. (List on page 2 of this form.)
PLEASE DELETE:
17.
Partners, Members, or Corporate Officers (List on page 2 of this
18.
Address(es) for my Rental Real Property, Rental Motor Vehicle,
form.)
Tour Vehicle and/or Car-Sharing Vehicle Business, and Transient
Accommodations. (List on page 2 of this form.)
19.
Trade Name or Doing Business As (DBA) Name:
MAILING ADDRESS
Signature of Owner, Partner or Member, Officer, or Duly Authorized Agent
HAWAII DEPARTMENT OF TAXATION
P.O. BOX 1425
Print Name of Signatory
HONOLULU, HI 96806-1425
03
FORM GEW-TA-RV-5
Title
Date
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