Indiana Department of Revenue Business Tax Application

Indiana Department of Revenue Form BT-1 Business Tax Application

A separate application is required for each business location. Please print legibly or type the information on this application.

Section A: Taxpayer Information

1. Federal Identification Number (FEIN):

2. Taxpayer Identification Number (TID):

3. Name of contact person responsible for filing tax forms:

4. Contact person's daytime telephone number: Ext.

5. Reason for filing this application:

Starting New Business

Business Under New Ownership

To Change Type of Organization

To Add Location to Existing Account

To Register for Other Type(s) of Tax

Other:

6. Owner name, legal name, partnership name, corporate name or other entity name:

Check if foreign address

B.

If sole owner (last name, first name, middle initial, suffix)

C.

Primary Address: D.

City: E. State: F. ZIP Code: G.

County: H.

Email Address: I.

7. Business trade name or DBA and physical location:

Check if foreign address

Name: B.

Street Address: C.

City: D. State: E. ZIP Code: F.

County: G. Township: H.

Business Location Telephone Number: I. J. Ext.

8. Type of organization:

Sole Proprietor Partnership LLP LP Corporation S Corp

LLC Nonprofit Fed Govt Other Govt Other:

9. Indiana Secretary of State Control #:

10. Corporations only:

A. State of Incorporation:

B. Date of Incorporation:

C. State of Commercial Domicile:

D. Date authorized to do business in Indiana:

E. Accounting period year ending date:

11. North American Industry Classification System (NAICS): Secondary codes:

12. Owner, Partners, or Officers (attach separate sheet if necessary)

13. Are you a Marketplace Facilitator?

14. Tax(es) to be registered for this business location:

A. Withholding Tax

B. County Innkeepers Tax

C. Food and Beverage Tax

D. Motor Vehicle Rental Excise Tax

E. Sales Tax

F. Private Employment Agency

G. Tire Fee

H. Heavy Equipment Rental Excise Tax

I. Peer to Peer Vehicle Excise Tax

Section B: Sales Tax Registration

1. Registration date of this location under this ownership:

2. Is this business seasonal? Yes No

Active months:

3. Will you provide lodging or accommodations for periods of less than 30 days? Yes No

4. Will prepared foods or beverages be sold/catered? Yes No

5. Will alcoholic beverages, beer, wine or packaged liquor be sold from this location? Yes No

ATC Permit Number: Expiration Date:

6. Will gasoline, gasohol or special fuels be sold through a metered pump? Yes No

7. Will cars or trucks (less than 11,000 lbs Gross Vehicle Weight) be rented for less than 30 days? Yes No

8. Do you occasionally make sales in the State of Indiana at fairs, flea markets, etc.? Yes No

9. Estimated monthly taxable sales: $

10. Do you sell tires? Yes No

11. Will Heavy Equipment be rented for less than 30 days from this location? Yes No

12. Are you registered for Streamline Sales Tax? Yes No

SSTID Number:

13. If reporting sales tax on a consolidated basis, is this location included in your consolidated account? Yes No

Reporting Number (TID):

Section C: Withholding Tax Registration

1. Accounting period year ending date:

2. Date taxes first withheld from an Indiana resident/employee:

3. Anticipated monthly wages paid to Indiana resident/employees: $

4. Mailing name and address for WTH tax returns:

Check if foreign address

In care of:

Street Address:

City: State: ZIP Code:

5. Are you a Race Team withholding income taxes for Race Team Members who are nonresident employees/independent contractors? Yes No

Section D: Food and Beverage Tax Registration

1. Date of first sales at this location under this ownership:

2. Enter county(ies), city(ies), and/or town(s) where prepared foods or beverages are sold or catered and list start dates:

Section E: County Innkeepers Tax Registration

1. Date room rentals or accommodations begin from this location:

Section F: Motor Vehicle Rental Excise Tax Registration

1. Date motor vehicle rental or leasing begins:

2. Tax District Number:

Section G: Tire Fee Registration

1. Date sales begin from this location:

Section H: Heavy Equipment Rental Excise Tax Registration

1. Date heavy equipment rental or leasing begins:

2. Tax District Number:

Section I: Peer to Peer Vehicle Sharing Excise Tax

1. Date vehicle sharing begins:

Section J: Marketplace Facilitator

1. Does this business operate a marketplace on which it facilitates sales to Indiana customers?

2. Does this marketplace facilitate the provision of accommodations to Indiana customers?

3. Does this marketplace facilitate the sale and delivery of prepared food to Indiana customers?

4. Does this marketplace facilitate the sharing of personal vehicles?

Section K: Signature Section

I hereby certify that the statements are correct.

This application must be signed by the owner, general partner, corporate officer, or resident agent before it will be accepted by the Department.

Additional Information

Contact the Department at (317) 232-2240 for more information regarding this application.

North American Industry Classification System (NAICS)

This form includes a long NAICS code listing in the PDF appendix. If needed, enter up to four applicable NAICS codes using the field provided in Section A.