Form B&L:TEFA "Application for an Alabama Scrap Tire Environmental Fee" - Alabama

What Is Form B&L:TEFA?

This is a legal form that was released by the Alabama Department of Revenue - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2017;
  • The latest edition provided by the Alabama Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form B&L:TEFA by clicking the link below or browse more documents and templates provided by the Alabama Department of Revenue.

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Download Form B&L:TEFA "Application for an Alabama Scrap Tire Environmental Fee" - Alabama

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A
D
R
LABAMA
EPARTMENT OF
EVENUE
B&L: TEFA
B
& L
T
D
5/17
Reset
USINESS
ICENSE
AX
IVISION
P.O. Box 327495 • Montgomery, AL 36132-7495 • (334) 353-7827 • Fax (334) 353-1809
www.revenue.alabama.gov
Application For An Alabama Scrap Tire Environmental Fee
A. APPLICANT INFORMATION
APPLICANT
FEIN/SSN
TRADE NAME OR DBA
ALABAMA SALES TAX NUMBER
CONTACT PERSON
TELEPHONE NUMBER
FAX NUMBER
E-MAIL ADDRESS
(        )
(        )
B. ADDRESS INFORMATION
PHYSICAL LOCATION (DO NOT USE P.O. BOX)
CITY
STATE
ZIP CODE
MAILING ADDRESS (IF DIFFERENT FROM ABOVE)
CITY
STATE
ZIP CODE
COUNTY WHERE BUSINESS LOCATED
EFFECTIVE DATE OF TIRE SALES
C. TYPE OF BUSINESS
Sole Owner
Partnership
Corporation
Association
LLC
Other (Specify) _______________________________________________________
State of incorporation/organization: ___________________________________
If LLC, have you elected to be taxed as a corporation under federal income tax laws?   
Yes
No. If yes, please attach a copy of Form 8832
SOLE PROPRIETORSHIP: provide owner. PARTNERSHIP: provide all partners. CORPORATION: provide all corporate officers.
ALL OTHERS: provide all general partners, members, or managers. (Attach additional pages if necessary.)
FULL LEGAL NAME
TITLE
SOCIAL SECURITY NUMBER
HOME ADDRESS
CITY
STATE
ZIP CODE
FULL LEGAL NAME
TITLE
SOCIAL SECURITY NUMBER
HOME ADDRESS
CITY
STATE
ZIP CODE
FULL LEGAL NAME
TITLE
SOCIAL SECURITY NUMBER
HOME ADDRESS
CITY
STATE
ZIP CODE
D. OTHER LOCATIONS
Are you filing for multiple locations?     
Yes     
No      If yes, list physical locations below or attach separate listing:
ADDRESS
CITY
ZIP CODE
ADDRESS
CITY
ZIP CODE
ADDRESS
CITY
ZIP CODE
Signature of Applicant
Date
You must contact the ADEM Scrap Tire Program at (334) 271-7988 to register as a scrap tire receiver.
OFFICE USE ONLY
______________________________________________
______________________________
ACCOUNT
Approval by Manager
NUMBER
A
D
R
LABAMA
EPARTMENT OF
EVENUE
B&L: TEFA
B
& L
T
D
5/17
Reset
USINESS
ICENSE
AX
IVISION
P.O. Box 327495 • Montgomery, AL 36132-7495 • (334) 353-7827 • Fax (334) 353-1809
www.revenue.alabama.gov
Application For An Alabama Scrap Tire Environmental Fee
A. APPLICANT INFORMATION
APPLICANT
FEIN/SSN
TRADE NAME OR DBA
ALABAMA SALES TAX NUMBER
CONTACT PERSON
TELEPHONE NUMBER
FAX NUMBER
E-MAIL ADDRESS
(        )
(        )
B. ADDRESS INFORMATION
PHYSICAL LOCATION (DO NOT USE P.O. BOX)
CITY
STATE
ZIP CODE
MAILING ADDRESS (IF DIFFERENT FROM ABOVE)
CITY
STATE
ZIP CODE
COUNTY WHERE BUSINESS LOCATED
EFFECTIVE DATE OF TIRE SALES
C. TYPE OF BUSINESS
Sole Owner
Partnership
Corporation
Association
LLC
Other (Specify) _______________________________________________________
State of incorporation/organization: ___________________________________
If LLC, have you elected to be taxed as a corporation under federal income tax laws?   
Yes
No. If yes, please attach a copy of Form 8832
SOLE PROPRIETORSHIP: provide owner. PARTNERSHIP: provide all partners. CORPORATION: provide all corporate officers.
ALL OTHERS: provide all general partners, members, or managers. (Attach additional pages if necessary.)
FULL LEGAL NAME
TITLE
SOCIAL SECURITY NUMBER
HOME ADDRESS
CITY
STATE
ZIP CODE
FULL LEGAL NAME
TITLE
SOCIAL SECURITY NUMBER
HOME ADDRESS
CITY
STATE
ZIP CODE
FULL LEGAL NAME
TITLE
SOCIAL SECURITY NUMBER
HOME ADDRESS
CITY
STATE
ZIP CODE
D. OTHER LOCATIONS
Are you filing for multiple locations?     
Yes     
No      If yes, list physical locations below or attach separate listing:
ADDRESS
CITY
ZIP CODE
ADDRESS
CITY
ZIP CODE
ADDRESS
CITY
ZIP CODE
Signature of Applicant
Date
You must contact the ADEM Scrap Tire Program at (334) 271-7988 to register as a scrap tire receiver.
OFFICE USE ONLY
______________________________________________
______________________________
ACCOUNT
Approval by Manager
NUMBER