Form Bb-1x - Basic Business Amended Application Page 2
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2FORM BB-1X
Page 2
(REV. 2012)
20. Filing period for:
(a) General Excise Tax....................................................................................
Monthly ..........
Quarterly ........
Semiannually
(b) Transient Accommodations Tax .................................................................
Monthly ..........
Quarterly ........
Semiannually
(c) Rental Motor Vehicle and Tour Vehicle Surcharge Tax ..............................
Monthly ..........
Quarterly ........
Semiannually
For items (a), (b), and (c):
Check monthly if you expect to pay more than $4,000 a year of taxes in the respective taxes;
Check quarterly if you expect to pay $4,000 or less a year in the respective taxes; or
Check semiannually if you expect to pay $2,000 or less a year in the respective taxes.
(d) Employer’s Withholding Tax .......................................................................
Monthly ..........
Quarterly
Check monthly if you expect to pay more than $5,000 a year in withholding taxes; or
Check quarterly if you expect to pay $5,000 or less a year in withholding taxes
(e) Unemployment Insurance Contributions ................................................... ...... .........................
Quarterly (This must be filed on a quarterly basis)
(f) Liquor Tax ..................................................................................................
Monthly
(This must be filed on a monthly basis)
(g) Cigarette and Tobacco Taxes ....................................................................
Monthly
(This must be filed on a monthly basis)
(h) Liquid Fuel Taxes ......................................................................................
Monthly
(This must be filed on a monthly basis)
21. Accounting period, check only one
Calendar Year (The 12-month period from January 1 to December 31.)
___ ___ / ___ ___ (A 12-month period ending the last day of any month other than December.)
Fiscal Year ending
22. Accounting method, check only one
Cash (Report income in the period when it was actually or constructively received.)
Accrual (Report income when you earn it, whether or not you actually receive it.)
23. Do you qualify for a disability exemption?
Yes
No
If yes, Form N-172 must be completed and submitted before the $2,000
exemption of gross income of any blind, deaf, or totally disabled person and rate of ½ of 1% on the remaining gross income can be allowed.
24. (a) List by island the address(es) of your rental real property (e.g., land, building, apartments, condominiums, or hotels or other transient lodging).
(b) List by island the address(es) of your rental motor vehicle and/or tour vehicle business locations.
(c) If a transient accommodation (TA) or a rental motor vehicle or tour vehicle (RVST) business location, place a check mark in the appropriate column on the right.
(d) Attach a separate sheet of paper for additional listings.
Check
Check
Address
Island
if TA
if RVST
25. For the Retail Tobacco Permit, list separately each retail location you own, operate, or control, and for retail locations that are vehicles, include the Vehicle Identification Number (VIN) of
each vehicle (Attach a separate sheet of paper if more space is required). Have you ever been cited for either a tobacco and/or liquor violation?
Yes
No
Vehicle Identification No. (VIN)
Name
Street Address
26. For the Liquid Fuel Retail Dealer’s Permit, list separately each branch or place of business (Attach a separate sheet of paper if more space is required).
Street Address
Island
27. Name of Parent Corporation
28. Parent Corporation’s FEIN
29. Parent Corporation’s Mailing Address
MAILING ADDRESSES & TELEPHONE NUMBERS
Hawaii Department of Taxation
P.O. Box 1425
Honolulu, HI 96806-1425
Telephone:
(808) 587-4242
Toll Free:
1-800-222-3229
Department of Labor and Industrial Relations
Unemployment Insurance Division
OAHU & MAINLAND
MAUI
HAWAII
KAUAI
830 Punchbowl St., #437
54 S. High St., #201
1990 Kinoole St., #101
3100 Kuhio Hwy C12
Honolulu, HI 96813
Wailuku, HI 96793
Hilo, HI 96720
Lihue, HI 96766
Telephone:
(808) 586-8913
Telephone:
(808) 984-8410
Telephone:
(808) 974-4086
Telephone:
(808) 274-3025
(808) 586-8914
DO NOT WRITE IN THIS SPACE
Type
Number
Date Issued
Effective FYE
Liquor Tax Permit
Cigarette Tax and Tobacco Tax License
Liquid Fuel Distributor’s License
Liquid Fuel Retail Dealer’s Permit
FORM BB-1X
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