Form R-1 - Business Registration Form Page 4

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SALES AND USE TAXES
1.
Sales Tax Business Location - enter the physical address where sales will take place. If you have multiple business
locations, please photocopy this section and complete for each location.
Check here if the location of your sales is the same as the Primary Business Address on page 3.
Street Address
_________________________________________________________________
City
__________________________
State ______
ZIP Code ______________
2.
Mailing Address – enter a mailing address specific for Sales Tax information.
Check here if same as the Primary Mailing Address on page 3.
Address or PO Box _______________________________________________________________
City
__________________________
State ______
ZIP Code ______________
3.
Contact Information – identify a contact person specific to Sales Tax information.
Check here if same as the Primary Business Contact on page 3.
Name
____________________________________
Phone Number
_______________________
Fax Number ________________________
4.
Identify the Sales Tax Types your Business will be responsible for remitting and the Effective Date (MM/DD/YY)
you became liable for that tax:
Retail Sales and Use Tax (in-state dealers)
Effective Date
_______________
This tax is imposed on gross receipts from retail sales or leases of tangible personal property or taxable services to
a consumer or to any person for any purpose other than for resale.
Use Tax (out-of-state dealers)
Effective Date
_______________
This tax is imposed on gross receipts from retail sales or leases of tangible personal property and/or taxable
services occurring outside Virginia and delivered for use, consumption, or storage in Virginia. The use tax also
applies to purchases, leases or rentals made in Virginia if the sales tax was not paid at the time of purchase, lease,
or rental.
Consumer Use Tax
Effective Date
_______________
This tax is imposed on personal property used, consumed or stored in Virginia but purchased outside the state that
would have been subject to retail sales tax if purchased in the state. The tax also applies to purchases, leases, or
rentals made in Virginia if the sales tax was not paid at the time of purchase, lease, or rental.
Tire Recycling Fee
Effective Date
_______________
This fee is levied on each new tire sold at retail in Virginia.
Vending Machine Sales Tax
Effective Date
_______________
This tax is paid by dealers placing vending machines through which they sell tangible personal property.
Attach a list identifying each City or County in which you will be operating a vending machine.
Communications Tax
Effective Date
_______________
This tax is paid by communications service providers who provide taxable communications services to customers.
A communications service is any electronic transmission of voice, data, audio, video, or other information by or
through any electronic, radio, satellite, cable, optical, microwave, or other medium or method regardless of the
protocol used for the transmission or conveyance. Communications services subject to the tax include: landline
4

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