New Account Registration Form
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1ALATAX NEW ACCOUNT REGISTRATION FORM
PLEASE FAX THIS COMPLETED FORM TO (205) 324-1538
1 - FEIN # ___________________________ OR Social Security # _________________________________
2 -
Corporation
Sole Proprietorship
Partnership
Professional Association
Other
City:___________________ County:_______________ State:___________
3 - Physical Location of Business:
4 - Indicate the Type of Tax and Rate You Will be Filing:
Sales Tax
Seller’s Use Tax
Consumer Use Tax
Other, please specify _____________________
General Rate
Automotive Rate
Mfg. Machine Rate
Agricultural Rate
Amusement Rate
Vending
5 – Indicate the Jurisdictions you will be filing tax in:
Alexander City
East Brewton
New Hope
Bibb Co.
Marshall Co.
Andalusia
Eclectic
Opelika
Bullock Co.
Monroe Co.
Anniston
Elberta
Opp
Choctaw Co.
Montgomery Co.
Atmore
Elmore (Town of)
Ozark
Clarke Co.
Perry Co.
Attalla
Evergreen
Phenix City
Clay Co.
Pike Co
Autaugaville
Flomaton
Powell
Conecuh Co.
Russell Co
Bessemer
Florala
Ragland
Covington Co.
Russell Co-PJ
Branchville
Forkland
Red Level
Dale Co. CL
Russell Co-CL
Brantley
Fyffe
Rutledge
Dale Co. exc. CL
Sumter Co.
Brewton
Gadsden
Samson
Dallas Co.
Tallapoosa Co.
Brilliant
Gardendale
Sand Rock
Elmore Co.
Wilcox Co.
Brundidge
Georgiana
Silverhill
Escambia Co.
Butler
Hayneville
Steele
Greene Co
Calera
Kimberly
Thorsby
Hale Co.
Camden
Kinsey
Troy
Henry Co.
Cedar Bluff
Lanett
Tuskegee
Houston Co.
Centre
Leesburg
Union Springs
Lamar Co.
Collinsville
Lipscomb
Uniontown
Lee Co. in CL
Columbiana
Livingston
Vestavia Hills
Lee Co. in PJ
Coosada
Luverne
Warrior
Lee Co. exc. CL
Cordova
Monroeville
Webb
Limestone Co.
Cowarts
Morris
Wedowee
Lowndes Co.
Cuba
Moundville
York
Macon Co.
Dothan
New Brockton
Marengo Co.
6 – Complete the following information: (All below information is required!)
Taxpayer’s Name:
_________________________________ Contact Person: __________________________
DBA Name:
_________________________________ Title:
_ __________________________
Mailing Address:
_________________________________ E-Mail Address:_________________________
_________________________________ Street Address: _________________________
City/State/Zip:
_________________________________ City/ State/Zip: _________________________
Phone: ________________________________
Fax: _________________________________
Begin Date:
_________________________________ SIC Code ____________________________
______________________________
__________________________
_____________________
Signature
Title
Date
Account Registration - ALATAX, Inc. 2001
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