Form S-1 - Vermont Application For Business Tax Account Page 2
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71G - Compliance Check
Has the Vermont Department of Taxes required a bond for this business entity or any business entity in which any person
listed above was an officer or held a 20% or more interest?
Yes (Attach explanation)
No
Has the Vermont Department of Taxes suspended or revoked a Sales and Use or Meals and Rooms tax license for this
business entity or any business entity in which any person listed above was an officer or held a 20% or more interest?
Yes (Attach explanation)
No
PART 2 - SALES AND USE TAX
Start Date (see instructions) _______ / ______ / ___________
Business Operation:
Year Round
Occasional
Seasonal
Months of Operation _____________________
Estimate of annual Vermont Sales and Use tax liability:
$500 or less
$501 - $2,500
Over $2,500
Name of Filing Service used (if any) __________________________________________________________________
Physical Location of Business: _____________________________________________________________
(Street address only - No PO Boxes)
______________________________________________________________________________________
City/Town
State
ZIP Code
Trade Name or d/b/a/ for this location: _________________________________________________________________
Brief description of business activity at this location (List in order of primary activity first).
1. ___________________________________________________________________________________________
2. ___________________________________________________________________________________________
3. ___________________________________________________________________________________________
Person to contact about Vermont Sales and Use Tax account:
Name ________________________________________________________________________________________
Telephone number: _____________________________
Fax number: ______________________________
e-mail address: ________________________________________________________________________________
Mailing Address for Sales and Use Tax account returns and information (if different from Part 1 address):
____________________________________________________________________________________________
Street, Road or PO Box
City/Town
State
ZIP Code
PART 3 - MEALS AND ROOMS TAX
Start Date (see instructions) _______ / ______ / ___________
Business Operation:
Year Round
Occasional
Seasonal
Months of Operation _____________________
Estimate of annual Vermont Meals and Rooms tax liability:
$500 or less
Over $500
Name of Filing Service used (if any) __________________________________________________________________
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