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INSTRUCTIONS STATE OF HAWAII — DEPARTMENT OF TAXATION
FORM A-6
(REV. 2019) INSTRUCTIONS FOR FORM A-6
TAX CLEARANCE APPLICATION
(NOTE: References to “married” and “spouse” are also references to “in a civil union” and “civil union partner,” respectively.)
GENERAL INSTRUCTIONS Line 3 — Applicant is a/an Line 8 — Contractor Licensing
• This form is used to obtain a State Tax Check the box which best describes your Indicate whether you are applying for your
Clearance. entity type. initial contractor’s license or renewing your
current license.
• This form may be used to obtain a State or If you are a Single Member LLC disregard-
Federal Tax Clearance for the purpose of ed as separate from the owner, enter the own- Line 9 — State Residency
entering into contracts/submitting bids with er’s FEIN/SSN in the space provided.
Enter the date you arrived in the State of
and/or seeking final payment of contracts If you are a Subsidiary Corporation, enter Hawaii or returned to the State of Hawaii if
from state or county agencies in Hawaii. the parent corporation’s name and FEIN in the your reason for applying is residency status.
Contractors winning the bids are not required space provided.
to have their subcontractors obtain a tax Line 10 — Accounting Period
clearance. If a Federal Tax Clearance is Line 4 — The Tax Clearance is Required For
required, Internal Revenue Service (IRS) If you file your tax returns on a calendar
Form 8821, or IRS Form 2848 is also required. Check the box(es) which correspond to year basis (1/1 — 12/31), check the first box. If
your reason(s) for obtaining the tax clearance. you file your tax returns on a fiscal year basis
• The current version of Form A-6 must be The asterisk (“ ”)*indicates the reason for other than a calendar year, check the second
used. Type or print clearly with a pen. After which a state and federal clearance is re- box, and enter the month and day your fiscal
approval, the front page of the application quired. year ends. For example, a corporation whose
will be your tax clearance certificate with a tax year is July 1 throughst June 30 wouldth
QR code presented in the State Approval Check the “Other” box if you are required to write “06/30” on the line provided.
Stamp Box. The QR code can be scanned obtain a tax clearance for the credit for school
to authenticate the tax clearance. repair and maintenance or for the purchase of Line 11 — Tax Exempt Organization
cigarette tax stamps at the reduced rate.
• Applications (Form A-6) are available at If you are a tax exempt organization, you
Department of Taxation and Internal Revenue Line 5 — Signature must enter the Internal Revenue Code section
that applies to your exempt status. For exam-
Service (IRS) offices in Hawaii, and may Signature. — The application must be ple: IRC §501(c)(3). Also, you must answer the
also be requested by calling the Department signed by an individual/sole proprietor/owner, questions in this section.
of Taxation on Oahu at 808-587-4242 or toll trustee, executor, corporate officer (president,
free at 1-800-222-3229. This form can be vice-president, secretary, treasurer, etc.) or Line 12 — Individual
downloaded from the Department of Taxa- general partner or member. An employee of
tion’s website at tax.hawaii.gov. your company or authorized agent may sign If you are an individual/sole proprietor who
• Vendors selling goods and services to state, the application if he/she possesses a valid is married, enter your spouse’s name and so-
city, or county agencies may register with power of attorney. Power of attorney forms are cial security number on the lines provided.
Hawaii Compliance Express and have their available at the Department of Taxation (Form
tax clearance status available online for all N-848) and IRS (Form 8821 or Form 2848) as Line 13 — If You Do Not Have a General
state, city, or county contracts. Go to https:// indicated on page 1 of the application. Un- Excise Tax License and Require a Tax
vendors.ehawaii.gov for more information. signed or unauthorized signatures on applica- Clearance
tions will be returned. If you do not have a general excise tax li-
LINE-BY-LINE INSTRUCTIONS cense and require a tax clearance, you must
Print Name. — Enter the name of the per-
Line 1 — Applicant Information son signing the application. complete this section. Contact the State De-
partment of Taxation if you have additional
Applicant’s Name. — Enter your legal Print Date/Telephone/Fax/Title. — Enter questions. Refer to page 2 of Form A-6 for the
name. The name appearing on your applica- the date the application is signed, and the tele- telephone number or mailing address.
tion must match the name on file with the phone/fax number which the Department of
State Department of Taxation, IRS, and, if ap- Taxation or IRS can call during business hours Filing the Application for Tax Clearance
plicable, the State Department of Commerce should any questions arise while processing
and Consumer Affairs. the application for tax clearance. Also enter Applications may be submitted either in
the title of the person signing the application. person, fax, by mail, or electronically. Mailing
Address. — Enter the address to which addresses and other contact information for
correspondence regarding this application for Line 6 — City, County, or State Govern- the State Department of Taxation and the IRS
tax clearance should be mailed. In most cas- ment Contract are provided on page 2 of the application.
es, the address should be that which is on file Indicate whether you are submitting a bid A “mailed-in” tax clearance application
with the Department of Taxation and/or IRS. for a contract, entering into a contract, have an generally takes 10 - 15 business days to pro-
DBA (Doing Business As)/Trade ongoing contract, completing a contract, and/ cess.
Name. — If you have a trade or business or waiting for final payment on a contract. If all required returns have been filed and
name which is different from your legal/regis- If you are requesting a tax clearance for a all required taxes, penalties, and interest have
tered name, enter that name here. completion/final payment of contract, please been paid, a “walked-in” tax clearance to any
Line 2 — Tax Identification Numbers provide the name, agency, and telephone district tax office will generally be processed
number of the contact person at the State or the same business day.
Hawaii Tax I.D. #. — Enter your tax identifi- County Agency in the spaces provided. Form A-6 also can be filed electronically
cation number. Enter “NONE” if you do not through our website at hitax.hawaii.gov. An
have one. Line 7 — Liquor Licensing
electronically filed tax clearance application
Federal Employer I.D. #. — Enter your For liquor licensing purposes, indicate generally takes 10 - 15 business days to pro-
9-digit federal employer identification number whether you are applying for an initial liquor cess. For more information, go to tax.hawaii.
(FEIN). Enter “NONE” if you do not have one. license, renewing your current liquor license, gov/eservices/.
transferring a liquor license, or applying for a
Social Security #. — If you are an individ- one time special event license.
ual/sole proprietor, enter your social security
number (SSN).