Form Ar-1r - Combined Business Tax Registration Form Page 6
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7SECTION W - OTHER TOBACCO PRODUCTS
78.
a) Date Activity Begins in AR
b) DBA (if applicable)
79.
Please check the applicable classification.
Retailer
Wholesaler
Manufacturer
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
80.
SECTION X - SOFT DRINK
81.
a) Date Activity Begins in AR
b) DBA (if applicable)
82.
Please check the applicable classification.
Retailer
Wholesaler
Manufacturer
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
83.
SECTION Y - BEEF
84.
a) Date Activity Begins in AR
b) DBA (if applicable)
85.
Please check the applicable classification.
Producer
Purchaser
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
86.
SECTION Z - CATFISH FEED
87.
a) Date Activity Begins in AR
b) DBA (if applicable)
88.
Please check the applicable classification.
Producer
Purchaser
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
89.
SECTION AA - CORN/GRAIN SORGHUM
90.
a) Date Activity Begins in AR
b) DBA (if applicable)
91.
Please check the applicable classification.
Producer
Purchaser
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
92.
SECTION AB - RICE
93.
a) Date Activity Begins in AR
b) DBA (if applicable)
94.
Please check the applicable classification.
Producer
Purchaser
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
95.
SECTION AC - SOYBEAN
96.
a) Date Activity Begins in AR
b) DBA (if applicable)
97.
Please check the applicable classification.
Producer
Purchaser
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
98.
SECTION AD - WHEAT
99.
a) Date Activity Begins in AR
b) DBA (if applicable)
100.
Please check the applicable classification.
Producer
Purchaser
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
101.
SECTION AE - BRUCELLOSIS/PSEUDORABIES
102.
a) Date Activity Begins in AR
b) DBA (if applicable)
103.
Please check the applicable classification.
Producer
Purchaser
a) Mailing Address (if different from Section B)
b) City
c) State
d) Zip Code
104.
Revised 08/10/2012
Page 6 of 7
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Parent category: Financial