Application for sales or use tax account

TUSCALOOSA COUNTY SPECIAL TAX BOARD

P O BOX 20738

TUSCALOOSA, AL 35402-0738

PHONE: [phone]

Fax: [phone]
APPLICATION FOR SALES OR USE TAX ACCOUNT
NEED A COPY OF OWNER’S OR ALL OFFICERS’ DRIVERS’ LICENSES

STATE OF ALABAMA TAX#____________________________________________________

FULL LEGAL NAME (SAME AS REGISTERED WITH THE STATE):

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NAME OF BUSINESS (DOING BUSINESS AS):
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TYPE OF BUSINESS: ___________________________________________________________
MAILING ADDRESS:
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PHYSICAL ADDRESS (IF MORE THAN ONE LOCATION, PLEASE LIST ALL):
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PHONE NUMBER: _________________________ FAX: ______________________________
CELLULAR NUMBER: _____________________ EMAIL: ___________________________
DATE OF BIRTH OF OWNER OR ALL OFFICERS, PARTNERS, ETC: _______________________________________________________________________
NAME OF CONTACT PERSON: __________________________________________________
BUSINESS START DATE IN TUSCALOOSA CO: ___________________________________
BUSINESS OWNERS NAME OR IF PARTNERSHIP, OR CORP. GIVE NAME, ADDRESS & PHONE NUMBER OF EACH OFFICER:
______________________________________________________________________________
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SIGNATURE: _________________________________________________________________