PDF document
- 1 -
                                                                                                     *0-0-0-001* 
                                                                                                            *0-0-0-001* 
                                 Wyoming Department of Revenue                                                 
                                                  th
                                 122 West 25  Street                                                           
                                 Cheyenne  WY  82002-0110                                                      
                                 http://revenue.wyo.gov                                                       Department Use Only 
                                                                                                              RID:__________________ 
                                 Sales/Use Tax License Application                                            Filing Freq:_____________ 
                                                                                                              License:________________ 
                                                                      
                      ALL LINES MUST BE COMPLETED IN ORDER TO PROCESS THIS APPLICATION 
 
     1. Ownership Name:________________________________________________ (1) ________________________   
                                                                                                              (federal identification number) 
                                  
     2. Date of     first Sale / Service in Wyoming______/_______/_______Estimated Monthly Sales Volume $________           
                                                                                       
     3. DBA/Doing Business As Name:                                                                                                               
     4. Please check one of the following that best describes your ownership          (spousal ownership is considered a partnership):           
         A. ________Association/Club                B. ________Corporation                                    C. ________Individual  
         D. ________Limited Partnership             E .________Limited Liability Company              F. ________Partnership 
         G. ________Other (explain)                 Date and State of Incorporation_____________________________                                  
          
         Note: Corporations must provide evidence of registration with your home state or Wyoming Secretary of State’s Office. 
         Please contact the Wyoming Secretary of State’s Office at 307-777-7311 with any questions regarding registration.         . 
                
       5.   Mailing Address:                                                                                                                      
                                 Street or PO Box                    City                            State                            Zip Code 
 
       6.   Location Address:                                                                                                                     
                                     Street                          City                            State                            Zip Code 
                                  
       7.   Internet E-Mail Address:________________________________ @                                                                            
      
       8.   Business Phone Number: (       )_______-________   (800)______-___________Fax No:(       )________-                                   
      
       9.   Authorized Contact:_________________________________________ Phone Number: (       )_______-                                          
      
     10. What Type of Sales does this business make?  Retail______Wholesale______Service______Manufacturer                                        
 
     11. Describe specifically the type of products and/or services this business provides, (ex: auto parts, computers and/or auto 
         repair, computer repair) give the percentage of each: total must equal 100% 
        A. __________________   _____%     B._____________________   ______%    C.____________________  _____% 
 
     12. Does this business sell “prepaid wireless communication access”, (ex: calling cards,                 Yes_______ No_______   
          wireless phones, re-charge/reload of minutes or wireless service for a fixed period of time.)                            
     13. Does this business sell liquor? If yes, list your WY Liquor license number___________ Yes_______ No_______  
     14. Does this business provide lodging?                                                                  Yes_______ No_______  
     15. Does this business have more than one lodging location?                                              Yes_______ No_______ 
     16.  Is this business located within the boundaries of an incorporated city or town in Wyoming?          Yes_______ No_______ 
     17. Does this business sell cigarettes, cigars, snuff, or other tobacco products?                        Yes_______ No_______ 
     18. Does this business sell propane, butane, liquefied gas, or compressed natural gas?                   Yes_______ No_______ 
     19.  Does this business ship/deliver products and/or service in any other WY city, town or county?     Yes_______ No_______ 
     20. Has this ownership ever had a Wyoming Sales/Use Tax License?                                         Yes_______ No_______   
     21. Does this business have more than one location in Wyoming?                                           Yes_______ No_______ 
     22. If this business has more than one location do you prefer to consolidate the licenses?               Yes_______ No_______ 
          If yes how many locations and their license numbers? ________________________________________________ 
         
        Note:  Original Signature(s) are required for all ownership types.  The business owner must sign for the individual 
        ownership, all partners must sign for partnerships, one major officer for a Corporation, one member or manager for a 
        Limited Liability Company and two partners for Limited Partnership.  Attach an additional signature page if needed.  
        Signatures must be original. 
          
         A.         Print Name:________________________________  Signature__________________________________________ 
                Address:   _________________________________ City:______________________State________Zip_________ 
                    Last four of SSN:__________________________    Title______________________________________________ 
   
         B.   Print Name:________________________________ Signature__________________________________________ 
                Address:   _________________________________ City:______________________State________Zip_________ 
                    Last four of SSN:__________________________    Title______________________________________________ 
   
                    Don’t forget!  *To complete all lines of this application in its entirety, including all required signatures. 
                              *Include the $60.00 non-refundable application fee.    
                              *Please make check payable to the Wyoming Department of Revenue.  
                              *For assistance completing the application please call (307) 777-5200. 
Rev 10/04/2018 



- 2 -
                           Wyoming Sales Use Tax License Application Instructions 
                                                        
#  Requested Information           Description 

1  Ownership Name                  This is the name of the ownership of the business or the legal name of the 
                                   business. It is the name of the corporation, LLC, partners in the partnership, 
                                   or your name if you are a sole proprietor. Example: ABC Suppliers Inc. 

1  (federal identification number) This is the Federal Employer Identification Number issued by the IRS. Not all 
                                   businesses are required to have an EIN. Please go to www.irs.gov for 
                                   assistance in obtaining a FREE EIN. 

2  Date of first Sale / Service in This is the date of your first sale transaction in Wyoming, or the date you will 
   Wyoming                         start your business. It can be a future date. 

3  DBA/Doing Business As Name      This is the name people will use to identify your business. It is sometimes 
                                   referred to as your trade name. It can be how you list your business in the 
                                   telephone book or on business cards. Example: ABC Widgets and Gidgets. 

4  Please check one of the         This goes along with the Ownership name and should be consistent. If your 
   following that best describes   ownership name is ABC Suppliers Inc, you should select Corporation.  Date 
   your ownership                  and State of Incorporation should be completed by all corporations and 
                                   LLC’s. 

5  Mailing Address                 The address we will use when mailing your tax returns, license certificate, 
                                   quarterly newsletters and any time sensitive notices from us.  

6  Location Address                This is the location of your business. It can not be a registered agent or 
                                   virtual office address. If you do not have a physical storefront, it needs to be 
                                   the address where your business records can be inspected or where your 
                                   customer can return an item. It may be your home address if you run an 
                                   online store, attend various craft shows, have a food truck, or similar 
                                   businesses. 

7  Internet E-mail Address         The email address that we may use to send forms or other requested 
                                   information to you. 

8  Business Phone Number           The phone number associated with your business, along with a toll free 
                                   number or fax number if you have them. 

9  Authorized Contact              A specific person we can call if we have questions about your account. Note 
                                   that we can not share certain information with a non-authorized contact, so 
                                   this person is crucial for timely resolution of issues associated with your 
                                   account. Anyone who signs the Sales/Use Tax Application is an authorized 
                                   contact. 

10 What type of sales does this    You may select more than one. Retail means a sale to the end user. 
   business make?                  Wholesale is a sale made to another business for them to sell to someone 
                                   else. Service is labor. Manufacturer is to take materials and turn them into a 
                                   different product (ie cloth into clothing, metal into dishes, wood into 
                                   furniture).Please refer to our Exemption Certificate Bulletin. 

11 Describe specifically the types If someone were to look up your business in the phone book, under which 
   of products or services this    category would they look? Auto sales? Hairdresser? Restaurant? C-Store? 
   business provides...            Please refer to our Bulletin, “Are You A Vendor?” 

12 Does this business sell prepaid Will you sell phone calling cards, prepaid cell phones, minute refills for pay 
   wireless communications         as you go phones?   
   access... 

13 Does this business sell liquor? Wyoming is an alcohol control state, so if you sell liquor, you must have 
                                   applied for and received a liquor license from the Wyoming Department of 
                                   Revenue, Liquor Division; please include the license number on your 
                                   application. 

14 Does this business provide      Do you provide overnight sleeping accommodations for transient guests? 
   lodging?                        This includes hotels, motels, campgrounds, RV parks and guest rooms. 
                                   Please review our Lodging Publication.  

15 Does this business have more    Each lodging location must have a separate license. 
   than one lodging location? 

16 Is this business located within Are you within the city or town limits? Do you have your water or trash 
   the boundaries of an            service through the city (inside boundaries), or do you have it through a third 
   incorporated city or town in    party (outside boundaries)? 
   Wyoming? 

17 Does this business sell         Do you sell products containing tobacco? (note that vaping supplies contain 
   cigarettes, cigars, snuff, or other  nicotine, not tobacco)  
   tobacco products? 

Rev 10/04/2018 



- 3 -
 18  Does this business sell         Do you sell propane, butane, liquefied gas, or compressed natural gas? 
     propane, butane, liquefied gas, 
     or compressed natural gas? 

 19  Does this business ship/deliver Do you do business in a Wyoming county other than the one in which you 
     products and/or service in any  are located, or if you are located out of state, do you ship or deliver products 
     other WY city, town or county   or services into any county in Wyoming? Please review our Sourcing 
                                     Bulletin. 

 20  Has this ownership ever had a   Have you had a license with us before, or do you have another license 
     Wyoming Sales/Use Tax           currently with us? 
     License? 

 21  Does this business have more    Does your business operate out of more than one location address in 
     than one location in Wyoming?   Wyoming?  

 22  If this business has more than  Would you like to report all of the taxes owed by all of your business 
     one location do you prefer to   locations on a single tax return? 
     consolidate the licenses? 

 22  If yes, how many locations?     This helps us verify that we have attached all of your licenses to a single 
                                     consolidated license. Please list all your licenses for your locations. 

 A B Signature block                 The name, address, signature and title of the responsible parties for the 
                                     business. If a sole proprietor, we require the owner’s signature and title. If a 
                                     partnership, we require each partner’s signature and title. If a corporation, we 
                                     require at least one major officer’s signature and title (President, Vice 
                                     President, Treasurer, Secretary). If an LLC, we require at least one member 
                                     or manager’s signature and title. If a Limited Liability Partnership, we require 
                                     signatures and titles of at least two partners. 
 
Rev 10/04/2018 






PDF file checksum: 915739811

(Plugin #1/9.12/13.0)