Wisconsin Temporary Event Operator And Seller Information Form printable pdf download

Wisconsin Temporary Event Operator And Seller Information Form

Wisconsin Temporary Event Operator and Seller Information

Information on this form is required under sec. 73.03(38), Wis. Stats.

Instructions on reverse side.

PART A: Event Information: To be completed by the operator of the temporary event

PART B: Operator Information: To be completed by the operator of the temporary event

1. Name and Address

2. Daytime Telephone Number (

)

4. Wisconsin Tax Account Number

If blank, check appropriate box:

No Taxable Sales

THIS IS NOT AN APPLICATION FOR A WISCONSIN TAX ACCOUNT – SEE INSTRUCTIONS

1. Legal Name

2. Business Name

3. Address (Street or Route)

4. City, State and Zip Code

5. Home Telephone Number (

)

Business Telephone Number (

)

6. Wisconsin Tax Account Number

X X

7. Social Security Number

X X

X X X

9. Check one box indicating the type of activity you intend to engage in at this event:

Display Only

Direct Sellers, Company Name

I declare that the information on this form is true and correct to the best of my knowledge and belief and that I am authorized to sign

this form.

Print Name:

Signature:

Date:

Information about temporary events, including forms, instructions and Common Questions can be found on the Department of Rev-

enue’s website at revenue.wi.gov/html/temevent.html. If you have additional questions, please contact the Department of Revenue

by email at

DORBusinessTax@revenue.wi.gov

or telephone at (608) 266-2776. See reverse side for submission instructions.

This Form May Be Reproduced

S-240 (R. 5-14)

Wisconsin Temporary Event Operator And Seller Information Form