SPENCERVILLE VILLAGE INCOME TAX DEPT.

P O BOX 57

SPENCERVILLE, OH  45887

419-647-4171

BUSINESS REGISTRATION

                                                                                                      

 

The information provided on this form will remain confidential and be used strictly for the Village of Spencerville Income Tax files to assist in preparing forms for compliance of the Village Income Tax Ordinance.  Please complete the form and return to our office within ten days of receipt.  Thank you for your cooperation.

 

Name and Physical Address of Business

_____________________________________________________________________________

 

_____________________________________________________________________________

 

_____________________________________________________________________________

 

Address to which tax forms are to be mailed

_____________________________________________________________________________

 

_____________________________________________________________________________

 

Type of Ownership:  ___ Proprietorship  ___Corporation  ___Partnership   ___ Non-Profit

                                 Other________________________________________________________

 

FEIN:  _______________________________________________________________________

 

Nature of business conducted

 

_____________________________________________________________________________

 

Accounting Period used for Federal Income Tax Purposes_______________________________

 

How many persons do you employee?_______________________________________________

 

Do you at any time during the year employ persons who are subject to the Village of Spencerville Income Tax and from whom you will not withhold the Income Tax?   If so, please list names and addresses of such employees.  (Note:  If business is located within the Village corporation there are mandatory employee withholding requirements per Village ordinance.)

 

_____________________________________________________________________________

 

_____________________________________________________________________________

  

Does business occupy, as tenant, real property (land/buildings) located within the Village of Spencerville rented from another party?   ___________________________________________

 

If so, to whom is rent paid?______________________________________________________

 

If place of business is outside of the Village of Spencerville do you have earnings resulting from activity inside of Spencerville corporation limits?_____________________________________

 

 

Other - Supplementary Information

 

_____________________________________________________________________________

 

_____________________________________________________________________________

 

_____________________________________________________________________________

 

Signature of Preparer ________________________________Title_________________________

 

Company_________________________________________ Date_________________________

 

Telephone________________________________________ Fax__________________________

 

 

 

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