Fillable Form 5.: APPLICATION FOR BUSINESS TAX LICENSE Knox

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Form 5.: APPLICATION FOR BUSINESS TAX LICENSE Knox

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APPLICATION FOR BUSINESS TAX LICENSE
Knox County Clerk
P.O. Box 1566 Knoxville, TN 37901
(865) 215-2392 www.knoxcounty.org/cler
k Hours: Monday – Friday 8-4:30
TOTAL APPLICATION FEE: Payable to “Knox County Clerk”……………..... $15.00
1.
WHAT TYPE OF LICENSE ARE YOU APPLYING FOR
Standard Minimal Activity
Fiscal Year End:
2.
REASON FOR APPLYING
NEW Business ADDITIONAL Location PURCHASE of Existing Business
3.
DATE BUSINESS BEGAN AT THIS LOCATION
(MM/DD/YYYY Format)
4.
TYPE OF OWNERSHIP
Proprietorship Marital Joint Ownership (other spouse’s SSN _______________________)
Corporation Partnership Single Member LLC Multi-Member LLC
Estate or Trust
5.
DESCRIBE THE BUSINESS ACTIVITY AT THIS LOCATION, STATING MAJOR PRODUCTS AND/OR SERVICES SOLD:
FOR OFFICE USE ONLY
CLASSIFICATION: 1A 1B 1C 1D 1E 2 3 4
6.
CONTACT PERSON’S INFORMATION
Name Email
7.
STATE BUSINESS TAX ACCOUNT NUMBER
TENNESSEE SECRETARY OF STATE ID NUMBER
SALES TAX NUMBER FOR THIS LOCATION
FEDERAL EMPLOYER IDENTIFICATION NUMBER
8.
BUSINESS MAILING ADDRESS BUSINESS NAME AND EXACT LOCATION
Name (Legal Name, If Different)
Business Name
P.O. Box, Street, Route, Hwy
Street or Hwy (Do Not Use P.O. Box, UPS Store box, or similar box)
Apartment or Suite Number
Apartment or Suite Number
City State Zip Code
City State Zip Code
Business Phone Number, Including Area Code
Business Fax Number, Including Area Code
COUNTY IN WHICH BUSINESS IS LOCATED IS BUSINESS LOCATED IN CITY LIMIT?
YES NO
9.
IDENTIFY OFFICERS, PARTNERS, OR INDIVIDUAL OR COMPANY OWNERS. ATTACH ADDITIONAL SHEET(S) IF NECESSARY
Name (First, Middle Initial, Last)
Home Telephone
Social Security Number FEIN ITIN
Street Address (Do Not Use P.O. Box)
City State Zip Code
Email Address
Name (First, Middle Initial, Last)
Home Telephone
Social Security Number FEIN ITIN
Street Address (Do Not Use P.O. Box)
City State Zip Code
Email Address
THE STATEMENTS MADE IN THIS APPLICATION ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
This application must be signed by the individual owner, a partner or an officer of the corporation. The signatory must be listed in Number 9.
Signature of Owner, Partner, or Officer (Do Not Print or Use Stamp) Title Date
Diversity Information
Asian Female
Asian Male
Black or African Female
Black or African Male
Caucasian Female
Caucasian Male
Disabled Female
Disabled Male
Hispanic or Latino Male
Hispanic or Latino Female
American Indian or Alaska Native
Female
American Indian or Alaska Native
Male
Native Hawaiian or other Pacific
Islander Female
Native Hawaiian or other Pacific
Islander Male
Not Applicable
By checking this box I wish to opt out of the collection of diversity information
Veteran Status
Veteran
Service-Disabled Veteran
By checking this box I wish to opt out of the collection of veteran status information
FOR OFFICE USE ONLY
Local Account Number
Business License Number
A
PPLICATION FOR KNOX COUNTY BUSINESS TAX LICENSE INSTRUCTIONS
1. Select between a Standard Business License, gross $10,000 or more annually, or a Minimal Activity
License, gross between $3000 and $9999.99.
2. Select the reason for which the application is being filed: new business, additional location, or the
purchase of an existing business.
3. Enter the date which the business began or will begin conducting business activities at the location for which
registration is being made.
4. Select the legal structure type of the business being registered.
5. Enter a description of the business activities being performed by the business at the location being registered.
Indicate the main products or services sold at this business location. Please be as detailed as possible.
6. Enter the name of a contact person for the business being registered. Enter the contact person’s email address.
7. I
f the business being registered has been issued a State Business Tax Account Number from the Tennessee
Department of Revenue, enter this number. Enter the Tennessee Secretary of State Identification number of th
e
b
usiness being registered, if applicable. If the business being registered currently has a sales and use tax account with
the Tennessee Department of Revenue, enter this number. If the business has applied for but not received a sales and
use tax account number, so indicate. If no number is required, so indicate. Enter the Federal Employer’s Identification
Number (FEIN) of the business being registered. If no FEIN is required, so indicate.
8. Enter the mailing address of the business being registered. Enter the legal name (if different from location name)
street address or post office box number, apartment or suite number if applicable, city, state, and zip code. Enter the
name and exact location address of the business being registered. Include the business name, street addre
ss,
a
partment or suite number, city state, and zip code. Post office boxes or UPS boxes cannot be used for the locatio
n
address. Enter the name of the county in which the business is located. Indicate whether the business is located
within the limits of a city in the county. If located in a city, enter the name of the city. NOTE: A business located
within the limits of a city may have a business tax obligation for both the county and the city. If so, the business must
obtain a business license from both the county and the city. Enter the business telephone number and business fax
number, if applicable.
9. E
nter the names, home addresses, and home telephone numbers of two owners, officers, or partners in the business
being registered. If the owner is an individual, enter the owner’s social security number and check the appropriate
box. If the owner is a business entity, enter the owner’s FEIN and check the appropriate box. Finally, check the box to
indicate whether the person is an individual or business entity owner, partner, officer, or member. This information is
critical. It will allow us to identify persons with whom we may discuss the business tax account when needed.
10. The application must be signed by an individual owner, partner, or officer of the business being registered. The
person who signs the application must be listed in Item 9 on the application form. Indicate the title of the person
signing the application (i.e., owner, partner, officer) and the date on which the application is signed.
11. D
iversity Information Section: Please select the best option. If you do not wish to provide this information simply
check the box to opt out.
12. V
eteran Status: Please select the best option. If you do not wish to provide this information simply check the box to
opt out.
Q
uestions? Please call (865) 215-2392 Monday – Friday 8:00am to 4:30pm EST
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Form 5.: APPLICATION FOR BUSINESS TAX LICENSE Knox

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Completed 18 July 2020

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