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City of Warren, Ohio Income Tax Division
BUSINESS QUESTIONNAIRE
This Questionnaire must be completed and returned to this office by
-----------' whether or not there is any liability for Warren
City Income Tax (Ordinance 9126/81 ).
BUSINESS NAME:
ADDRESS:
If all tax is being paid under another name, list name, address and account number below:
1. Date your business started ( or will start ) in Warren
(If this account is a courtesy withholding for a Warren Resident please indicate
that on the above line and proceed to question 4.)
How acquired (Check one)
o New Business
o Purchased
o Reorganization
o Other
List name of former owner, if any, below:
2. List actual Warren Location of your business:
3. Principal business activities: __________ _
4. Do you have employees? o Yes o No If yes, how many? __
Date you first had employees_/_/_
Approximate monthly payroll applicable to the City of Warren$ _____ _
(You are required to make monthly withholding payments if your liability
exceeds $200.00 per month. The Warren city tax rate is 2.5 %.)
5. Federal Employer Identification Number: __________ _
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