Form S-1 - Vermont Application For Business Tax Account (Page 7 of 7) in pdf

Trade Name or Doing Business As (d/b/a) Name If you conduct business under a name other than indicated in Part 1B, print the name

here.

Example: ABC Corporation doing business as Trader Tim

Business Activity List the business activities with the primary business activity first. This information is used to make sure you have a

tax account for all necessary taxes and to send notices of tax changes.

Person to contact Print the name and contact information for someone the Department may call on questions about this tax account.

Mailing Address for Withholding Tax Account If you want just the Withholding tax returns, correspondence or other information to

go to an address different from the one in Part 1D, print here.

PART 5 Corporation Income Tax or Business Income (Entity) Tax

Start Date This is the date the business started activity in Vermont.

Fiscal Year End Print the last day of the tax year. Example: calendar year December 31; fiscal year June 30

Person to contact Print the name, telephone number, and other contact information.

Mailing Address for Tax Account If you want just the tax returns, correspondence or other information to go to an address different

from the one in Part 1D, print here.

Physical Location of Business Print the street/road name, city/town and state where the business is located.

Records Location Print the address where the tax records are kept if different from the one in Part 1D.

Federal Consolidated Group Print the name and FEIN of the parent corporation.

PART 6 Other Taxes

Fuel Gross Receipt Print the date the business started making sales of fuels subject to this tax.

Telecommunications Print the date the business started making sales of telecommunication services subject to this tax.

Local Option Tax Print the date the business started making sales of items subject to this tax. If doing business in multiple locations,

print the name of the local option town. Please include city or town designation. Examples: Manchester; Williston; Stratton

PART 7 Previous Ownership

Note: Buying an existing business requires notification to the Vermont Department of Taxes 10 days prior to the purchase. If notice is

not given, you may become liable for the previous owner’s outstanding business tax liability.

PART 8 Certification

The owner or business officer responsible for collection and remitting taxes is required to certify that the information provided in this

application is true, correct and complete.

Form S-1 - Vermont Application For Business Tax Account Page 7