Oklahoma Business Registration Application For Nonresident Contractors Form Page 16

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40005
Oklahoma Business Registration
Number
of Copies
Application for Nonresident Contractors
Attached:
Owner’s Name (same as Item 4)
BTRG
AP
FEIN/SSN:
Withholding Tax
IV.
6. Do you now or do you intend to withhold Oklahoma Income Tax from employees?
Yes
No
(a) If “yes” on item 6, do you expect to withhold more than $500 per quarter?
Yes
No
(b) If “yes” on item 6, date you will begin/began withholding Oklahoma Income Tax: / /
(month/day/year)
(c) Are you required to make federal withholding tax deposits more frequently
than once a month? ............................................................................................
Yes
No
7. What FEIN will you use to report withholding tax?
(if different than
Section III, Item 3)
Physical Location and Classification Information
V.
OFFICE USE
ONLY
8. Trade Name of Business: (DBA)
9. (a) Physical Location of Project:
(See instructions)
Status:
Street and Number or Directions (Do not use post office box or rural route number)
WH
City, State, Zip and County
10. Location Phone: (
)
Location Fax: ( )
Approved
Location Email:
11. What type of contract work will you be doing in Oklahoma? (Be specific):
Denied
12. Will you purchase materials and supplies outside Oklahoma on which sales tax has
not been paid? (See intsructions on page 10) ..............................
Yes
No
Fee -
VI.
If you are posting cash to comply with the nonresident contractors bond requirement,
please enter the amount you are posting here. A bond is required for contracts over $100,000.00.
C
Fee Type
Fee Tax Code
Total
Use Tax
......Total Amount Due
Cash Bond .. $ ________________.00 .....CSF
.. $ ________________ .00
Make Checks Payable to: Oklahoma Tax Commission
COPO
VII. Signature -
A sole owner, general partner, corporate officer, or authorized representative
must sign this application.
I, the undersigned applicant or authorized representative, or if a corporation, a responsible corporate officer for reporting
SIC Code
and remitting taxes, declare under the penalties of perjury that I have examined this application and attachments and to the
best of my knowledge the facts set forth are true and correct, and that the requirements hereunder will be carried out in ac-
cordance with the laws of the State of Oklahoma and the rules and regulations of the Oklahoma Tax Commission. I further
NAICS Code
acknowledge and agree that sales, withholding and motor fuel taxes are trust funds for the State of Oklahoma and that any
use of these trust funds other than timely remittance to the State of Oklahoma is embezzlement and can result in criminal
prosecution.
Form Type:
Type or print
name and title
Long
Sign Name
Electronic
and Date
Mandatory inclusion of Social Security and/or Federal Employer Identification Number is required on forms filed with the
Oklahoma Tax Commission pursuant to Title 68 of the Oklahoma Statutes and regulations thereunder, for identification
purposes, and are deemed part of the confidential files and record of the Oklahoma Tax Commission. The Oklahoma Tax
Commission is not required to give actual notice of changes in any state tax law.
B

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