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APPLICATION FOR TAXPAYER NUMBER
PARISH OF RAPIDES
P O Box 671 * Alexandria, Louisiana * 71309-0671
Phone (318) 445-0296 * Fax (318) 449-4532 * Email: info@rpst.org * www.laota.com
Reason for Applying
□ Started new business ___________________ □ Opening additional location □ Change of name
Date business began
□ Purchased ongoing business □ Merger □ Other
__________________________________________ __________________________________________
Previous owner or merger name Trade name of previous owner
Parish account number: Other information:
Louisiana Sales Tax Number ______________________________________ □Applied For None □
Federal Identification Number _____________________________________ □ Applied For □None
Federal Standard Industrial Code __________________ if unknown, please leave blank
How many other locations in Rapides Parish Total locations under same ownership
Legal Name(s) (individual, partners or corporation)
Trade name of business
□ Within Alexandria City Corp Limits □ Within Town of Ball Corp Limits □ Within Town of Cheneyville Corp Limits
□ Within Pineville City Corp Limits □ Within Town of Boyce Corp Limits □ Within Village of Forest Hill Corp Limits
□ Within Town of Glenmora Corp Limits □ Within Town of Woodworth Corp Limits □ Within Village of McNary Corp Limits
□ Within Town of Lecompte Corp Limits □ Within Rapides Parish □ Outside Rapides Parish
Business Location (street, route or highway – NOT P.O. Box) City State Zip Telephone
( )
Address for receiving tax forms & correspondence (If same location, write “same”) City State Zip Telephone
( )
Contact Person Phone Number Fax Number e-mail address Web Site Address
Location of Accounting Records City State Zip Telephone
( )
Type of Organization
□ Individual □ Partnership □ Corporation □ LLC □ LLP □ Governmental □Non-Profit □ Other _____________
If sole owner (individual)
_________________________________________________ _____ _____ _____ - _____ _____- _____ _____ _____ _____
Name Social Security Number
_________________________________________________________________________________(_____)___________________
Home Address City State Zip Telephone
If Corporation, LLC, LLP, or Partnership, please attach the following: name, title, social security number, home address and
telephone number of officers, members, managers or partners and Articles of Incorporation or Organization
_________________________________________________________________________________(_____)____________________
Agent for service or process: name physical address City State Zip Telephone
Nature of Business
□ Retail Sales □ Wholesale ____________________ □ Repair Service □Manufacturing/Fabrications
provide W #
□ Retail Service □ Contractor □ Other _______________
Date of first sale within Rapides Parish or date business started at this location ____________________________________________
___________________________________________________________________________________________________________
Describe in detail your business: type of sales, activity or service you perform
Requested reporting status □ Monthly □ Quarterly □ Annual □ Occasional/Irregular
Reporting frequency and filing status will be determined by the Administrator according to parish policy. Businesses with a location within the parish will automatically be registered to file on a monthly basis.
Occasional/irregular filers are intended for those businesses (1) that do not have a location within the parish and do not intend on doing business on a regular basis or (2) businesses that performs services that are not taxable.
□ OLT Only □ OLT & Sales Tax □ Sales Tax Only
I affirm that the information given on this application is true and correct.
_____________________________________________ ____________________________________________ _________________
Signature of Applicant or Preparer Title Date
Revised 10/04
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