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For Office Use Only
ACCT #
Date:
City of Toledo
Division of Taxation
One Government Center, Ste 2070, Toledo, OH 43604, Office (419) 245-1662, FAX (419) 936-2320
Email: incometax@toledo.oh.gov
New Business Registration Form
Business/Account Type:
(R) (B) (C) (B) (W)
Schedule C or E Form 1065 Form 1120/1120S Form 1041 Withholding
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FEDERAL TAX ID # (If Applicable) Toledo Business Name
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Business Name Toledo Address (if different)
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Business Address Toledo Address City, State, Zip
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Business City, State, Zip Mailing Address (if different)
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Business Phone # Mailing Address City, State, Zip
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Business Fax # Email Address
1. Starting date of Toledo activities _________________________________________
2. Are there now or will there be employees subject to Toledo income tax? Yes______ No______
Will you be filing monthly (withholding > $200/month)? Yes ______ No ______ Payroll starting date _______________
3. Accounting period: Calendar Year? ___________ or Fiscal Year Ending ________________________________
4. Nature of business _________________________________________________________________________________
5. If your address is not in Toledo, do you conduct business within Toledo city limits? Yes_________ No_____________
Corporate Officers:
Name Residential Address Social Security #:
President: ________________________________________________________________________________
Treasurer: ________________________________________________________________________________
Partners: (attach additional sheets if necessary):
Name Residential Address Social Security #:
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Sole Proprietor: (including Single Member LLC):
Name Residential Address Social Security #:
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Signature ___________________________________________ Title_____________________________________
Printed Name ________________________________________ Date ____________________________________
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