Form ST 900 Application for an Ohio Direct Payment Permit - Ohio

Form ST900 is a Ohio Department of Taxation form also known as the "Application For An Ohio Direct Payment Permit". The latest edition of the form was released in March 1, 2016 and is available for digital filing.

Download an up-to-date Form ST900 in PDF-format down below or look it up on the Ohio Department of Taxation Forms website.

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ST 900
Prescribed 3/16
Audit Division
P.O. Box 183014
Columbus, OH 43218-3014
Application for an Ohio Direct Payment Permit
The undersigned consumer hereby makes application pursuant to Ohio Revised Code (R.C.) section 5739.031 for authority to pay the
sales tax levied by R.C. sections 5739.02, 5739.021, 5739.023 and 5739.026, and the use tax levied under R.C. sections 5741.02,
5741.021, 5741.022 and 5741.023.
Please type or print clearly. Please complete all sections or the application may be denied.
1. Legal entity name
Trade name
2. Tax return mailing address
3. Person to contact regarding application (include telephone no. and e-mail address)
4. Federal employer identification number, or if none assigned for reporting federal taxes, please enter your Social Security number.
FEIN
Social Security number
5. Check whether business operates as:
Sole proprietor
Partnership/LLP
C corporation
Fiduciary
Limited liability company
S corporation
6. If it is a partnership/LLP or limited liability company, provide the names and addresses of the partners or members:
Name
Street address
City
State
ZIP code
Name
Street address
City
State
ZIP code
Name
Street address
City
State
ZIP code
If more than three, attach a separate sheet listing the remaining partners/members’ information and check the box:
7. If it is a C corporation or an S corporation, provide the names and addresses of the officers:
Name/title
Street address
City
State
ZIP code
Name/title
Street address
City
State
ZIP code
Name/title
Street address
City
State
ZIP code
If more than three, attach a separate sheet listing the remaining officers’ information and check the box:
8. Business description:
9. NAICS code
Estimated annual amount and number of taxable purchases:
$ Amount
# of transactions
10. Number of plants, divisions or other facilities to be included under this application:
Name
Name
Address
Address
If more than two, attach a separate sheet listing the information for the remaining locations and check the box:
- 1 -
ST 900
Prescribed 3/16
Audit Division
P.O. Box 183014
Columbus, OH 43218-3014
Application for an Ohio Direct Payment Permit
The undersigned consumer hereby makes application pursuant to Ohio Revised Code (R.C.) section 5739.031 for authority to pay the
sales tax levied by R.C. sections 5739.02, 5739.021, 5739.023 and 5739.026, and the use tax levied under R.C. sections 5741.02,
5741.021, 5741.022 and 5741.023.
Please type or print clearly. Please complete all sections or the application may be denied.
1. Legal entity name
Trade name
2. Tax return mailing address
3. Person to contact regarding application (include telephone no. and e-mail address)
4. Federal employer identification number, or if none assigned for reporting federal taxes, please enter your Social Security number.
FEIN
Social Security number
5. Check whether business operates as:
Sole proprietor
Partnership/LLP
C corporation
Fiduciary
Limited liability company
S corporation
6. If it is a partnership/LLP or limited liability company, provide the names and addresses of the partners or members:
Name
Street address
City
State
ZIP code
Name
Street address
City
State
ZIP code
Name
Street address
City
State
ZIP code
If more than three, attach a separate sheet listing the remaining partners/members’ information and check the box:
7. If it is a C corporation or an S corporation, provide the names and addresses of the officers:
Name/title
Street address
City
State
ZIP code
Name/title
Street address
City
State
ZIP code
Name/title
Street address
City
State
ZIP code
If more than three, attach a separate sheet listing the remaining officers’ information and check the box:
8. Business description:
9. NAICS code
Estimated annual amount and number of taxable purchases:
$ Amount
# of transactions
10. Number of plants, divisions or other facilities to be included under this application:
Name
Name
Address
Address
If more than two, attach a separate sheet listing the information for the remaining locations and check the box:
- 1 -
ST 900
Prescribed 3/16
11. Number of plants, divisions or other facilities in Ohio not to be included under this application:
Name
Name
Address
Address
Direct payment #
98 -
Direct payment #
98 -
Consumer’s use tax #
97 -
Consumer’s use tax # 97 -
None
None
If more than two, attach a separate sheet listing the information for the remaining locations and check the box:
I hereby acknowledge these responsibilities and declare the information provided above to be true and correct and to the best of my
knowledge and belief.
Signed
Title
Date
Phone number
MAIL APPLICATION TO:
Ohio Department of Taxation
Attention: Audit Support
Audit Division
P.O. Box 183014
Columbus, Ohio 43218-3014
UPS/Fed Ex, etc.
4485 Northland Ridge Blvd.
Columbus, OH 43229
OR FAX APPLICATION TO:
Ohio Department of Taxation
Attention: Audit Support
Audit Division
(614) 387-2071
- 2 -
ST 900
Prescribed 3/16
Taxpayer Information Report
Instructions: Please complete all sections of this form with the requested information.
1. Ohio license/charter number (issued by the Ohio Secretary of State):
2. Check the box for each type of Ohio tax return filed. In addition, provide the Ohio account number for each type of tax (attach a sepa-
rate list if there are numerous accounts).
Tax Type
Ohio Account Number
Effective Date
Date Closed
Sales Tax/Seller’s Use
Consumer’s Use/Direct Pay
Financial Institution
Petroleum Activities
Pass-through Entity (use FEIN)
Employer Withholding
Individual Income (use SSN)
Commercial Activity
3. Provide a list of all entities where the taxpayer, directly or indirectly, (i) owns more than 50% of the voting stock of a corporation, or
(ii) has more than a 5% ownership interest in a pass-through entity, that is conducting business in Ohio (attach a separate list if more
space is needed).
Entity Name
% of Ownership
FEIN
4. Provide a list of all entities which, directly or indirectly, (i) own more than 50% of the taxpayer’s voting stock, or (ii) have more than a
5% ownership interest in the taxpayer that is a pass-through entity (attach a separate list if more space is needed).
Entity Name
FEIN
% of Ownership
5. Has the taxpayer filed for protection under a U.S. Bankruptcy Court? Yes
No
If yes, provide the date of filing
- 3 -
ST 900
Prescribed 3/16
Responsible Party Questionnaire
We ask that each individual who was either: 1) an officer, member, manager or trustee; or 2) an employee (having control or supervision
of or charged with the responsibility of filing returns and making payment) of the business entity complete this questionnaire.
1. Answer the following questions. If additional space is necessary, attach additional sheets.
Who is responsible for the overall fiscal re-
Who prepares Ohio business tax reports/
Who has the authority to sign checks to
sponsibilities?
returns?
pay for business tax liabilities?
Who actually performs the execution of the
Who assigns the responsibility to fi le Ohio
Who actually signs checks to pay for busi-
overall fi scal responsibilities?
business tax reports/returns?
ness tax liabilities?
Who has the authority to prepare Ohio
Who actually files Ohio business tax re-
Who assigns the responsibility to sign
business tax reports/returns?
ports/returns?
Ohio business tax returns/reports?
Who has the authority to assign the re-
Who has the responsibility for retaining,
Who exercises management control or au-
sponsibility for exercising management
directing or otherwise exercising control
thority over employees who were respon-
control or authority over employees who
over outside accountants, bookkeepers,
sible for preparing, signing or fi ling Ohio
are responsible for preparing, signing or
or other persons who are charged with fil-
business tax reports/returns?
filing Ohio business tax reports/returns?
ing the Ohio business tax reports/returns?
2. Provide a list of all shareholders or members that owned more than 5% of the value of the business including their Social Security
number and home address.
Individual / Shareholder /Member
SSN
Home Address
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Download Form ST 900 Application for an Ohio Direct Payment Permit - Ohio

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