Free TC-69B Additional Business Locations for a Sales Tax Account - Utah

Utah State Tax Commission 210 N 1950 W, SLC, UT 84134 www.tax.utah.gov

Additional Business Locations for a Sales Tax Account

TC-69B
Rev. 12/08

1 -- General Information
1a. Social Security Number (SSN)
(required for individual sole proprietor)

Federal Employer Identification Number (EIN)
(required for all entities other than sole proprietor)

1b. Existing Sales Tax Account Number
(required for all accounts, if issued)

S T C
1c. Name of Business Entity - PRINT
Owner's street address If you are a sole proprietor, write your name here Daytime phone number

Cell phone number

City

County

State

ZIP code

Business website address (URL)

1d. Certain Sales Activities Mark "yes" for each question below that applies to any of the outlets you are reporting: a. Will you have sales of grocery food? ...................................................................................... b. Will you sell motor vehicles, aircraft, watercraft, manufactured homes, modular homes or mobile homes in municipalities imposing the resort communities tax? ................................ c. Will you have retail sales of new tires? .................................................................................. d. Are you a restaurant? .............................................................................................................. e. Will you rent motor vehicles to customers for 30 days or less? ............................................. Yes Yes Yes Yes Yes No No No No No

2 -- Additional/New Business Locations
DBA/Business Name Business or trade name at this physical location Physical street address of business (P.O. Box not acceptable) City County Business start-date for this location Business telephone number State ZIP code

Office Use Only County City Code SIC Code USTC SIC NAICS

Required: Local government issuing business license for this location Business Description If business or product is different from main business location, describe here for this location.

Lodging Services: Will you provide motel, hotel, trailer court, campground or other lodging services at this location?

Yes

No

a. G

b. X

c. W

d. T

e. F

f. L

Continued on next page (back side)

DBA/Business Name Business or trade name at this physical location Physical street address of business (P.O. Box not acceptable) City County

Business start-date for this location Business telephone number State ZIP code

Office Use Only County City Code SIC Code USTC SIC NAICS

Required: Local government issuing business license for this location Business Description If business or product is different from main business location, describe here for this location.

Lodging Services: Will you provide motel, hotel, trailer court, campground or other lodging services at this location?

Yes

No
Business start-date for this location Business telephone number State ZIP code

a. G

b. X

c. W

d. T

e. F

f. L

DBA/Business Name Business or trade name at this physical location Physical street address of business (P.O. Box not acceptable) City County

Office Use Only County City Code SIC Code USTC SIC NAICS

Required: Local government issuing business license for this location Business Description If business or product is different from main business location, describe here for this location.

Lodging Services: Will you provide motel, hotel, trailer court, campground or other lodging services at this location?

Yes

No

a. G

b. X

c. W

d. T

e. F

f. L

3 -- Authorized Signature
Signature of Authorized Applicant or Owner (Application will not be accepted without original signature) Date

SIGN HERE

Additional Business Locations for Sales Tax Accounts
General Information
Use this form to register additional business locations for a new or existing sales tax account.

Instructions
1a. A valid Social Security Number or Federal Employer Identification Number must be provided. 1b. If you are already registered with the Tax Commission and you are adding locations to an existing sales tax account, your Sales Tax Account Number is also required. 1c. You must provide the owner's name, daytime phone number, street address (PO Box not acceptable), city, county, state and ZIP. 2. You must provide all information for each location: · DBA/business name · Business telephone number · Physical street address of business · City, County, State and Zip code · Local government issuing business license · Business description, if business or product is different than at the main business location 3. The form must be signed by an authorized applicant or owner. Return the completed form to the Tax Commission at the following address:

Master File Maintenance Utah State Tax Commission 210 North 1950 West Salt Lake City, UT 84134-3310