Form 001.1 - Temporary Business Operations
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1*0-0-205-099*
*0-0-205-099*
Wyoming Department of Revenue
Excise Tax Division
122 W. 25th Street, Herschler Bldg.
Department Use Only
Cheyenne, Wyoming 82002-0110
RID:__________________
License:_______________
Fling Freq:_____________
Temporary Business Operations
1. Business Name: ___________________________________________________________________
2. Ownership Name:_________________________________________________________________
3. Partners:______________________________________ SSN______________________________
_______________________________________SSN______________________________
_______________________________________SSN______________________________
4. Please check one of the following that best describes your ownership (spousal ownership is
considered a partnership):
A. ________Association/Club
B. ________Corporation
C. ________Individual
D. ________Limited Partnership E .________Limited Liability Company F. ________Partnership
G. ________Other(explain)
5. Mailing address:________________________________________________________________________
Street or PO Box
City
State
Zip Code
6. Location Address:______________________________________________________________________
Street
City
State
Zip Code
7. Contact Phone Number:_________________________________________________________________
Area code and number, please list any toll free numbers used.
8. Sales Event____________________________________________________________________________
(gun show, Frontier Days, church bazaar etc.)
9. Sales Location__________________________________________________________________________
(City and County in Wyoming)
10. Sales Dates____________________________________________________________________________
(List date you will be making temporary sales in Wyoming)
Print Name:_____________________________________Signature_________________________________
Address:______________________________City:___________________State________Zip__________
SSN:__________________________________Title____________________________________________
Print Name:_____________________________________Signature_________________________________
Address: _____________________________City:___________________State________Zip__________
SSN:__________________________________Title____________________________________________
Print Name:_____________________________________Signature_________________________________
Address: ____________________________City:____________________State________Zip_________
SSN:_________________________________Title_____________________________________________
Wyoming Laws require all businesses and individuals to register with the Department of Revenue prior to
conducting sales in this State. Should you have any questions regarding Wyoming Tax Law Requirements,
please contact the Wyoming Department of Revenue, Excise Tax Division, Taxpayer Services Section at 122
West 25th Street, Herschler Building 2nd Floor West, Cheyenne, WY 82002-0110 Phone (307) 777-5200 --
FAX (307) 777-3632 or visit our Website at: .
ETS Form 001.1 Revised: 04/25/2011
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