State Sales Tax / Reseller's Permit Application

"*" indicates required fields

Select State for Registration

Please Select State for Registration ( Required )*

Please select the State the business is requesting for new registration.

Total: Registration & Fees

Expedited Services is included at no additional charge - Payment is by Credit Card only at this time.

Is the Company seeking to register in One single state?*

Typically, most new businesses register in one state.

Yes, One Single State Application

Multiple State ( Two or more ) Applications

For Additional Registrations, please select the States below. This is optional and only applies if you wish to register in more than one state.

Please Select Second State Registration ( Optional )

Please select the Second State the business is requesting for new registration ( Optional )

Please Select Third State Registration ( Optional )

Please select the Third State the business is requesting for new registration ( Optional )

Total: Registration & Fees

Expedited Services is included at no additional charge - Payment is by Credit Card only at this time.

Select Business Structure

Select Business Structure*

Sole Proprietor - A Single Owner / Proprietor

Partnership - Two (2) + Persons, without a Corporate Structure

Corporation

Limited Liability Corporation

State of Partnership Agreement

State of ( or proposed State ) the Partnership will operate and conduct business

State of Incorporation

State of Filing ( or proposed State of filing )

State of Limited Liability Corporation

State of Filing ( or proposed State of filing )

Business Start Date*

Company Address and Phone

Business Primary Phone*

Physical Business Address*

Street Address City ZIP Code

Physical Business - County / Township*

Ownership Information

Owner Name*

First Last

Owner's Date of Birth*

Owner Social Security Number*

Please include hyphens XXX-XX-XXX ; for verification purposes.

Owner Address same as Physical Business Address*

Owner Address

Street Address City ZIP Code

Owner #2- Information

Owner #2- Name*

First Last

Owner's Date of Birth*

Owner #2 Social Security Number

Please include hyphens XXX-XX-XXX ; for verification purposes.

Owner #2- Address same as Physical Business Address*

Owner #2- Address

Street Address City ZIP Code

Please Enter Business Purpose*

What does the business function? ex. - Hair Salon, Ride Sharing ( Uber / Lyft ) Car Dealership, Vacation Rental Sharing

Company - Secretary of State SOS Number - ( if applicable )

Does the company have an Employer Identification number ( EIN ) ?

An EIN has nine numerical digits in this format XX-XXXXXXX .

Enter Company Employment Identification Number ( Existing )

Use hyphens, enter in the following format: XX-XXXXXXX

Payment Information

Total Amount*

Phone Number - For Company Verification*

A representative may call this number to verify the information.

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Driver License Number*

Credit Card Billing Address*

Please enter the billing address of the credit card.

Street Address City ZIP Code

Credit Card Authorization Consent Agreement*

***** Please scroll and read and agree to the Credit Card Authorization Consent Agreement

I am an authorized user of the credit card. “ I “ refers to the cardholder / authorized user.

I understand my card will be pre-authorized, and a hold will be placed on the credit card for the exact amount of the charge.

I understand the information is verified on the application for errors. At times, the information verification process may add additional time. I understand this may create a delay in the processing of the application.

I understand as this is a unique service for the business information entered, and a refund will be issued only if the business is registered, or if the application for the company is rejected; if this applies to your application, your card will either not be charged or will be refunded.

I understand the information must be verified on the application submitted, and any errors, intentional or otherwise, may create a delay in the processing of your application.

Once the application is reviewed and the application is processed, I understand I will receive an email confirmation, at which point my credit card will be charged.

I am authorizing a single, one (1) time credit card charge to be processed through License Tax Sales Services.

I understand no additional charges will be authorized, and only the last four digits of the credit card are kept on file, solely for record keeping purposes.

I authorize a charge for the above amount to the credit card indicated in this authorization form according to the terms outlined above.

This payment authorization is for the services described above, for the amount indicated above only, and is valid for one time use only.

I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form.

This authorization is for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to your account.

Accept Consent for Credit Card Authorization Consent Agreement ( required )

Please note charges will appear on the credit card as* Licensing Registration Services *

{Company Name:9} - Application

Consent & Signature

Authorized Electronic Signature*

online tax identification number application form

Company Information

Select State for Registration

Select Business Structure

Company Address and Phone

Ownership Information

Payment Information

Consent & Signature