Form 78-005a Business Tax Permit Registration - Iowa

Form 78-005a or the "Business Tax Permit Registration" is a form issued by the Iowa Department of Revenue.

The form was last revised in November 17, 2014 and is available for digital filing. Download an up-to-date Form 78-005a in PDF-format down below or look it up on the Iowa Department of Revenue Forms website.

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Iowa Department of Revenue
Iowa Business Tax Permit Registration
www.iowa.gov/tax
Please type or print legibly. Complete both pages. Incomplete
4. Previous Owner
applications will delay processing. You are allowed to conduct
If purchasing an existing business, provide prior owner’s name.
business after you submit your application. It may take up to six
weeks before you receive your permit number.
5. Type of Products or Services Sold:
1. Location Name/Address
Product/Service
You must provide the street address where your business is located.
Federal Employer Identification Number (FEIN)
(If you have applied but not yet received an FEIN, write “applied for”)
6. Sales Tax Permit
(no fee)
Start date for selling at retail (MM/DD/YY)
Social Security Number (SSN)
(Required for sole proprietor or individual single member LLC)
Filing frequency (must check one)
Annually – collect less than $120 tax/year
Legal name (
Quarterly – collect less than $500 tax/month
Sole proprietor or individual single member LLC fill in last name, first name)
Monthly – collect more than $500 tax/month
Trade name
(doing business as)
Semi-monthly – collect more than $5,000 tax/month
(electronic payment required)
Location address
( Must be a street address. Do not write PO Box.)
Sales related taxes and permits (check box if applicable)
Hotel/Motel (no fee)
City
State
ZIP+4
Check this box if your business is a hotel, motel, inn, bed
and breakfast, or cabin with sleeping quarters.
A list of Iowa counties is available at www.iowa.gov/tax
IA county name
IA county number
Automobile Rental Tax (no fee)
If you rent automobiles to customers, you must collect this
Phone 1
Ext.
tax. Automobile rental tax is always filed quarterly.
)
Phone 2
Ext.
Household Hazardous Material Permit (HHM) (fee
See Information
Section or SafeSmartSolutions.org
for
Fax #
explanation of HHM permits.
Regular ($25 fee) ❑ Special ($125 fee or more)
Email
When you pay by check, you authorize the Department to convert
.
Date business established
your check to a one-time electronic banking transaction
Consolidated? See Information Section 6
State in which established
Check box if you have more than one location and want to
file consolidated returns.
2. Mailing Name/Address
Enter the number of locations to file consolidated.
Send mail to the address provided below. If you want mail sent to
0-00-
Enter your current consolidated permit number if
different addresses for different tax types, include a separate sheet
you want to add a new location.
listing the mailing addresses by tax type.
Name
7. Consumer’s Use Tax
Permit (no fee)
Mailing address
This permit is for those located in Iowa who purchase taxable goods
or services consumed in Iowa for which sales tax is not paid when the
City
State
ZIP+4
purchases are made.
Phone 1
Ext.
Start date for making purchases (MM/DD/YY)
Phone 2
Ext.
Filing frequency (must check one)
Annually – owe less than $120 tax/year
Email
Quarterly – owe more than $120 tax/year
8. Out-of-State Retailer’s Use Tax
3. Type of Ownership (must check only one)
(no fee)
See Information Section 3
Retailers making taxable sales in Iowa from an out-of-state location
must register to collect retailer’s use tax.
Corporation
Start date for selling in Iowa (MM/DD/YY)
Partnership
Association
Filing frequency (must check one)
Government
Annually – collect less than $120 tax/year
Limited liability co (LLC) filing on corporation, S corporation, or
Quarterly – collect less than $1,500 tax/month
partnership income return
Monthly – collect more than $1,500 tax/month
Individual single-member LLC filing on individual income return
Sole proprietor (One person and not an LLC)
78-005a(11/17/14)
Iowa Department of Revenue
Iowa Business Tax Permit Registration
www.iowa.gov/tax
Please type or print legibly. Complete both pages. Incomplete
4. Previous Owner
applications will delay processing. You are allowed to conduct
If purchasing an existing business, provide prior owner’s name.
business after you submit your application. It may take up to six
weeks before you receive your permit number.
5. Type of Products or Services Sold:
1. Location Name/Address
Product/Service
You must provide the street address where your business is located.
Federal Employer Identification Number (FEIN)
(If you have applied but not yet received an FEIN, write “applied for”)
6. Sales Tax Permit
(no fee)
Start date for selling at retail (MM/DD/YY)
Social Security Number (SSN)
(Required for sole proprietor or individual single member LLC)
Filing frequency (must check one)
Annually – collect less than $120 tax/year
Legal name (
Quarterly – collect less than $500 tax/month
Sole proprietor or individual single member LLC fill in last name, first name)
Monthly – collect more than $500 tax/month
Trade name
(doing business as)
Semi-monthly – collect more than $5,000 tax/month
(electronic payment required)
Location address
( Must be a street address. Do not write PO Box.)
Sales related taxes and permits (check box if applicable)
Hotel/Motel (no fee)
City
State
ZIP+4
Check this box if your business is a hotel, motel, inn, bed
and breakfast, or cabin with sleeping quarters.
A list of Iowa counties is available at www.iowa.gov/tax
IA county name
IA county number
Automobile Rental Tax (no fee)
If you rent automobiles to customers, you must collect this
Phone 1
Ext.
tax. Automobile rental tax is always filed quarterly.
)
Phone 2
Ext.
Household Hazardous Material Permit (HHM) (fee
See Information
Section or SafeSmartSolutions.org
for
Fax #
explanation of HHM permits.
Regular ($25 fee) ❑ Special ($125 fee or more)
Email
When you pay by check, you authorize the Department to convert
.
Date business established
your check to a one-time electronic banking transaction
Consolidated? See Information Section 6
State in which established
Check box if you have more than one location and want to
file consolidated returns.
2. Mailing Name/Address
Enter the number of locations to file consolidated.
Send mail to the address provided below. If you want mail sent to
0-00-
Enter your current consolidated permit number if
different addresses for different tax types, include a separate sheet
you want to add a new location.
listing the mailing addresses by tax type.
Name
7. Consumer’s Use Tax
Permit (no fee)
Mailing address
This permit is for those located in Iowa who purchase taxable goods
or services consumed in Iowa for which sales tax is not paid when the
City
State
ZIP+4
purchases are made.
Phone 1
Ext.
Start date for making purchases (MM/DD/YY)
Phone 2
Ext.
Filing frequency (must check one)
Annually – owe less than $120 tax/year
Email
Quarterly – owe more than $120 tax/year
8. Out-of-State Retailer’s Use Tax
3. Type of Ownership (must check only one)
(no fee)
See Information Section 3
Retailers making taxable sales in Iowa from an out-of-state location
must register to collect retailer’s use tax.
Corporation
Start date for selling in Iowa (MM/DD/YY)
Partnership
Association
Filing frequency (must check one)
Government
Annually – collect less than $120 tax/year
Limited liability co (LLC) filing on corporation, S corporation, or
Quarterly – collect less than $1,500 tax/month
partnership income return
Monthly – collect more than $1,500 tax/month
Individual single-member LLC filing on individual income return
Sole proprietor (One person and not an LLC)
78-005a(11/17/14)
Iowa Business Tax Permit Registration, page 2
9. Withholding Tax (no fee)
Information
Note: A return must be filed even if you had no activity or no tax
Complete this section if you have employees or withhold money from
due, or until you cancel your permit.
other types of income.
To apply for a license and/or permit not listed on this form, contact
Start date for withholding (MM/DD/YY)
Taxpayer Services. See contact information below.
Filing frequency (must check one)
Section 1: Location Name/Address
Quarterly – collect less than $500 tax/month
All businesses must provide an FEIN except for:
Monthly – collect more than $500 tax/month
 A sole proprietor who does not need a withholding permit.
Semi-monthly – collect more than $10,000 tax/month
 A single member LLC filing on individual income tax who does
(electronic payment required)
not need a withholding permit.
Withholding Agent - see Information Section 9
Section 3:
Type of Ownership
Note:
At least one withholding agent is required.
 Sole proprietor is one person. Spouses cannot be registered as
A payroll service is not a withholding agent.
a sole proprietor.
 Individual single-member LLC is an LLC with only one member
Withholding agent’s name
that does not elect to be treated as a corporation. Single-
Withholding agent’s SSN
member LLC income is reported on the owner’s income tax
return.
Withholding agent’s
personal address
Section 6: Sales Tax Permit - Consolidated Filers
Consolidated r eturns may be filed by a retailer with more than
one sales tax permit. To become consolidated, include a list of
10. Owners, General Partners, Corporate
businesses, their locations, and sales tax permit numbers.
Officers, and Responsible Parties
Consolidated permit holders cannot file annually. All sales tax
Print the name, SSN, and address of all individuals who are owners,
permits included in the consolidated account must have the
same legal owner, SSN and/or FEIN. Automobile rental and
partners, officers, or responsible parties. Include additional sheets if
hotel/motel permits cannot be consolidated.
necessary.
Household Hazardous Material (HHM) Permit
Individual name
A permit must be obtained for each location selling HHM on a
SSN
retail basis. Manufacturers/distributors that utilize independent
agents to sell person to person at a consumer’s home may
Personal address
purchase one permit at a fee of $25 for the first $3 million in
sales. An additional $100 fee is charged for each subsequent
increment of $3 million in sales. Common HHMs include:
Individual name
motor oil, filters, fuel additives, degreasers, waxes, polishes,
solvents, and others. Not HHMs: detergents, soaps, or
SSN
medications.
For more information on product types and
permit requirements visit SafeSmartSolutions.org
Personal address
Fees are not prorated or refunded. Your proof of payment
constitutes a permit pursuant to Iowa Code 455.7. Your
permit is valid through June 30 and must be renewed by
July 1. A renewal notice will be mailed to you. Permits will
11. Signature
not be renewed until payment is received.
Note: This application must be signed by an owner, a partner, or a
Section 9: Withholding Tax Registration
corporate officer listed above.
 Withholding agent: any person who is obligated to pay or has
Signature
control of paying or does pay any Iowa wages. The term also
Print name
includes anyone who is responsible for filing returns and
remitting tax to the Department.
SSN
Date
 Withholding
agents
are
personally,
individually,
and
corporately liable to the State of Iowa for withholding and
Contact name
Phone
paying money withheld. If a withholding agent fails to withhold
and pay the required amount, that amount may be assessed
Email
against the withholding agent.
After your Business Tax Registration form has been processed, you
Questions? Contact Taxpayer Services
will receive a tax permit number and Business eFile Number (BEN)
Phone:
515-281-3114 or 800-367-3388
letter in the mail. Information is available at www.iowa.gov/tax.
Email:
idr@iowa.gov
eFile & Pay: www.iowa.gov/tax
For Office Use Only
Register Online:
www.iowa.gov/tax
Or submit this form by:
Fax:
515-281-3906, ATTN: Registration Services.
Mail:
Registration Services
Iowa Department of Revenue
PO Box 10470
Des Moines, IA 50306-0470
78-005b(11/17/14)

Download Form 78-005a Business Tax Permit Registration - Iowa

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