Form 48 - Business Registration (Page 2 of 2) in pdf

Form 48 - Business Registration Page 2

CONTRACTOR INFORMATION

MUNICIPALITY:

BUILDING PERMIT #:

TOTAL CONTRACT AMOUNT: $

ADDRESS OF CONSTRUCTION SITE:

As the contractor, will your company be withholding local income tax from all

employees on the job?

YES

OFFICER/OWNER NAME

SOCIAL SECURITY OR

ESTIMATED

NUMBER OF

ESTIMATED

COMPANY/ADDRESS - CITY, STATE AND ZIP

TRADE

PHONE NUMBER

FEDERAL I.D. NUMBER

START DATE

EMPLOYEES

WAGES PER MONTH

If necessary attach a separate sheet

The information requested on this form is essential to the establishment of your account and will be held

in strict confidence. Please complete and sign this Registration Form and return within 15 days. Prompt

completion of this form now can save you the expenditure of additional time and effort in the future. If you

have any questions please contact the Business Registration Department at one of the numbers below.

Thank you for your cooperation.

SEND RESPONSE TO:

REGIONAL INCOME TAX AGENCY

CLEVELAND LOCAL:

(440) 526-0900

TDD:

(440) 526-5332

ATTN: BUSINESS REGISTRATION

COLUMBUS LOCAL:

(614) 538-0512

TOLL FREE:

1-(800) 860-RITA (7482)

P.O. BOX 477900

YOUNGSTOWN LOCAL:

(330) 743-3400

FAX:

(440) 526-3136

BROADVIEW HEIGHTS, OH 44147-7900

Form 48 - Business Registration Page 2