Form S-1 - Vermont Application For Business Tax Account Page 3
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7PART 3 - MEALS AND ROOMS TAX (continued)
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 Meals and Rooms Tax account:
Name ________________________________________________________________________________________
Telephone number: _____________________________
Fax number: ______________________________
e-mail address: ________________________________________________________________________________
Mailing Address for Meals and Rooms Tax account returns and information (if different from Part 1 address):
____________________________________________________________________________________________
Street, Road or PO Box
City/Town
State
ZIP Code
PART 4 - WITHHOLDING TAX
Start Date (see instructions) _______ / ______ / ___________
Estimate of Vermont Withholding tax liability per Quarter:
Less than $2,499
$2,500 - $8,999
$9,000 or more (requires EFT filing)
Reporting by:
Paper return
EFT Credit
EFT Debit
Name of Payroll 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. ___________________________________________________________________________________________
Contact for Vermont Withholding Tax:
Name ________________________________________________________________________________________
Telephone number: _____________________________
Fax number: ______________________________
e-mail address: ________________________________________________________________________________
Mailing Address for Withholding Tax account returns and information (if different from Part 1 address):
____________________________________________________________________________________________
Street, Road or PO Box
City/Town
State
ZIP Code
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