Withholding and Business registration 
                        Wooster Income Tax Department 
                        PO Box 1088  Wooster, OH  44691 
                     330-263-5226 (phone)   330-263-5262 (fax) 
                                              www.woosteroh.com 
                                               
Company Name:__________________________Phone#: _______________________ 
Local business or job-site address: _________________________________________ 
Federal ID: _____________________ 
 
 1. Nature of business conducted (NAICS # if available) _________________ 
 2. Fiscal year end  ___________________________ 
 3. Type of ownership   ______ sole proprietorship      ______ corporation/ S corp 
                                             ______ partnership                   ______ Non-profit/Other 
 4. Initial date of business in Wooster  _________________ 
 5. Did you recently or do you expect to have employees working in Wooster? _____ 
 6. Do you wish to set up a courtesy withholding account for employees who are  
       Wooster residents but do not perform work within the City of Wooster? ______ 
 7. Do you use an outside payroll company? _______ If so, name of payroll service?   
    _____________________________________     
 8. If you have answered “yes” to questions 5 or 6 , please complete the following: 
 
Send withholding report tax forms to the following address: 
Name:       _____________________________________________ 
Attn:       _____________________________________________ 
Address:    _____________________________________________ 
City:       _____________________  State: _______  Zip Code:  ___________ 
 
For partnerships and sole proprietors, please complete the following information: 
Name, address and social security # of partners or sole proprietor: 
 
 A) __________________________________________________________ 
 B) __________________________________________________________ 
 C) __________________________________________________________ 
 
Send income tax returns to (if same as withholding forms, write “SAME”) 
Name:       _____________________________________________ 
Attn:       _____________________________________________ 
Address:    _____________________________________________ 
City:       _____________________  State: _______  Zip Code:  ___________ 
 
Please list any independent contractors used to perform services within the City of 
Wooster. Also, if you rent property, please give the owner’s name and address. (Attach 
additional sheet if necessary). 
_______________________________________________________________________ 
Information is true and correct (signature)  _________________________________