Online Registration – Gravity Form | TAX ID SERVICES ORGANIZATION

The information entered in the following form is used for obtaining a State Sales Tax Certificate and/or an Employer Identification Number (EIN). Necessary entries are marked with a red asterisk. As certain information below may not pertain to the company, not all form fields are required.
Type of Tax Identification Number Request*
EIN & State Sales Tax ID Number - $150
$0.00
State Sales Tax Number Only - $100
$0.00
EIN Only - $50
$0.00
For State Sales Tax Number Requests, Select a State
Physical Location of Company*

Company Information ( required )
Physical Business Address [Cannot be a Post office Box]
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of COUNTY and/or TOWNSHIP*
Business Mailing Postal Address SAME AS Physical Business Address Above
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Owner's Information
Business Mailing Postal Address [ Post Office Box Acceptable ]
Primary Owner's Name / Responsible Person's Name SAME AS Contact Name
Primary Owner's Name
First Last
Primary Owner's Address SAME AS Physical Business Address
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Owner's Social Security Number*
Primary Owner's Date of Birth*
MM slash DD slash YYYY

Business Activity Description
Please Enter Company Purpose*
If necessary, enter additional company notes below.
Expedite Request
- No
- Yes (+$25)
Total
$0.00
ELECTRONIC SIGNATURE
Please ensure that all necessary fields are completed. Incomplete submissions will result in processing delays. All information is stored securely & used only to process your tax id number request. Under penalty of perjury, I certify all the above information is true to the best of my knowledge.
X -TYPE NAME HERE*

Online Registration – Gravity Form