Form BT-1 Business Tax Application - Indiana

Form bt-1 is a Indiana Department of Revenue form also known as the "Business Tax Application". The latest edition of the form was released in January 1, 2000 and is available for digital filing.

Download a fillable PDF version of the Form bt-1 down below or find it on Indiana Department of Revenue Forms website.

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Indiana Department of Revenue
Business Tax Application
Form BT-1
SF 43760
(Please print legibly or type the information on this application.)
(Revised 1-00)
A separate application is required for each business location.
Section A: Taxpayer Information (see instructions on page 1)
Contact the Department at (317) 615-2700 for more information regarding this application.
Federal
If this business is currently registered for
1.
2.
Identification
any Indiana tax under this ownership, enter
Number:
your Taxpayer Identification Number:
3.
Owner name, Legal name, Partnership name,
Corporate name or Other entity name:
If sole owner (Last name, First name, Middle Initial:
Mailing Address:
IN
City:
State:
Zip Code:
County:
4.
Check the type of organization of this business:
Sole Proprietor
Partnership
LLP
Corporation
LLC
Fed Govt
Other Govt
Other
5. All corporations answer the following questions: Otherwise, proceed to Question 6.
A. State of Incorporation:
B. Date of Incorporation:
C. State of Commercial Domicile:
Month
Day
Year
D. If not incorporated in Indiana, enter the
E. Accounting period
.
date authorized to do business in Indiana.
year ending date:
Month
Day
Year
Month
Day
6. Owner, Partners, or Officers (Attach separate sheet if necessary.)
Social Security Numbers are required in accordance with IC 4-1-8-1.
Social Security Number
Street Address
City
State
Zip Code
Last Name, First Name, Middle Initial
Title
7.
Name of contact person: (Person responsible for filing tax forms)
8.
Contact person's Daytime Telephone Number:
EXT
9.
Business trade name or DBA:
(This name and address is for the business location.)
Street Mailing Address:
(P.O. Box numbers cannot be used as a business location address.)
City:
State:
Zip Code:
County:
Township:
Tax District Number:(Motor Vehicle Rental only)
10. Business Location Telephone Number:
11.
North American Industry
Classification System (NAICS):
Please enter a primary and
P R I M A R Y
EXT
any secondary code(s) that
may apply.
Indiana Department of Revenue
Business Tax Application
Form BT-1
SF 43760
(Please print legibly or type the information on this application.)
(Revised 1-00)
A separate application is required for each business location.
Section A: Taxpayer Information (see instructions on page 1)
Contact the Department at (317) 615-2700 for more information regarding this application.
Federal
If this business is currently registered for
1.
2.
Identification
any Indiana tax under this ownership, enter
Number:
your Taxpayer Identification Number:
3.
Owner name, Legal name, Partnership name,
Corporate name or Other entity name:
If sole owner (Last name, First name, Middle Initial:
Mailing Address:
IN
City:
State:
Zip Code:
County:
4.
Check the type of organization of this business:
Sole Proprietor
Partnership
LLP
Corporation
LLC
Fed Govt
Other Govt
Other
5. All corporations answer the following questions: Otherwise, proceed to Question 6.
A. State of Incorporation:
B. Date of Incorporation:
C. State of Commercial Domicile:
Month
Day
Year
D. If not incorporated in Indiana, enter the
E. Accounting period
.
date authorized to do business in Indiana.
year ending date:
Month
Day
Year
Month
Day
6. Owner, Partners, or Officers (Attach separate sheet if necessary.)
Social Security Numbers are required in accordance with IC 4-1-8-1.
Social Security Number
Street Address
City
State
Zip Code
Last Name, First Name, Middle Initial
Title
7.
Name of contact person: (Person responsible for filing tax forms)
8.
Contact person's Daytime Telephone Number:
EXT
9.
Business trade name or DBA:
(This name and address is for the business location.)
Street Mailing Address:
(P.O. Box numbers cannot be used as a business location address.)
City:
State:
Zip Code:
County:
Township:
Tax District Number:(Motor Vehicle Rental only)
10. Business Location Telephone Number:
11.
North American Industry
Classification System (NAICS):
Please enter a primary and
P R I M A R Y
EXT
any secondary code(s) that
may apply.
(Please print legibly or type the information on this application.)
Business Tax Application
Page 2a
Tax(es) to be Registered for this Business Location
(Check all that apply.)
Sales Tax ($25.00 nonrefundable registration fee required per location;
County Innkeepers Tax (Complete Section E.)
complete Section B for a Registered Retail Merchants Certificate.)
Motor Vehicle Rental Excise Tax (Complete Section F.)
Withholding Tax (Complete Section C.)
Prepaid Gasoline Sales Tax ($100.00 registration fee
Out-of-State Use Tax (Complete Section B.)
required for qualified distributors; complete Section G.)
Food and Beverage Tax (Complete Section D.)
Section B: Sales Tax/Out-Of-State Use Tax Registration (see instructions on page 2)
($25.00 Nonrefundable Registration Fee for Retail Merchants Certificate) (No Fee for Out-of-State Use Tax Certificate)
Contact the Department at (317) 233-4015 for more information regarding these taxes.
1. Date of first sales at this location under this ownership:
2. Estimated monthly taxable sales: $
(see instructions on page 2)
Month
Year
3.
Is this business seasonal?
Yes
No
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Nov
Dec
If yes, check active months.
Oct
Check the appropriate responses.
Check the appropriate responses.
Yes
No
Yes
No
4.
Will you provide lodging or accommodations for periods of less than
9.
Will cars or trucks (less than 11,000 lbs Gross Vehicle Weight) be
thirty (30) days? If yes,complete Section E ....................................
rented for less than thirty (30) days from this location?..................
If yes, complete Section F.
5.
Will prepared foods or beverages be sold?......................................
If yes, complete Section D
10.
Will gasoline, gasohol or special fuels be sold through a
metered pump?............................................................................
6.
Will alcoholic beverages, beer, wine or packaged liquor be sold from
this location?....................................................................................
11.
Are you a refiner, distributor or a terminal operator which
If yes, enter your ABC Permit Number
supplies gasoline to retail outlets?.................................................
If yes, and you wish to become a Qualified Distributor,
complete Section G.
7.
Expiration Date
12.
Do you occasionally make sales in the State of Indiana at fairs,
Month
Day
flea markets, etc.?.............................................................................
8.
If you are reporting sales tax on a consolidated basis, is this location
to be included in your consolidated account? .................................
13.
Is income at this location directly derived from the retail sales of
If yes, enter your Reporting Number.
tobacco products?..............................................................................
14.
If yes, from vending machines only?...............................................
15.
Mailing name and address for sales tax returns (if different from Section A, Line 3):
In care of:
Street Address:
City:
State:
Zip Code:
Section C: Withholding Tax Registration (see instructions on page 2)
(No Registration Fee)
Contact the Department at (317) 233-4016 for more information regarding this tax.
1. Are you withholding on a nonresident shareholder, partner or beneficiary? Yes
No
5. Date taxes first withheld from an Indiana resident/
employee under this ownership:
2. Is this a one time annual distribution of income? Yes
No
3. Accounting Period: Year Ending Date
Month
Year
Month
Day
6. Anticipated monthly wages paid to Indiana resident/ employees:
4. Are you withholding on Professional Athletes? Yes
No
$
7. Mailing name and address for withholding tax returns (if different from Section A, Line 3):
In care of:
Street Address:
City:
State:
Zip Code:
Business Tax Application
Page 3a
(Please print legibly or type the information on this application.)
Section D: Food and Beverage Tax Registration (see instructions on page 2)
(No Registration Fee)
Contact the Department at (317) 233-4015 for more information regarding this tax.
Contact the Department at (317) 233-4015 for more information regarding this tax.
County
Municipality
2. Will prepared foods or beverages be catered
Date of first sales at this location under this
1.
(City or Town)
ownership:
from this location into other counties?
1. _______________
_______________
Yes
No
3. If yes, enter the name(s) of the county(ies)
2. _______________
_______________
Month
Year
and associated municipality.
3. _______________
_______________
4. _______________
_______________
Section E: County Innkeepers Tax Registration (see instructions on page 2)
(No Registration Fee)
Contact the Department at (317) 233-4015 for more information regarding this tax.
1. Date room rentals or accommodations begin
from this location:
Month
Year
Section F: Motor Vehicle Rental Excise Tax Registration (see instructions on page 3)
(No Registration Fee)
Contact the Department at (317) 233-4015 for more information regarding this tax.
1. Date motor vehicle rental or leasing begins:
Month
Year
2. If the address shown on Section A, Line 9 is in Indiana, make sure that a tax district number has been entered on that line.
3. If you are renting or leasing from a location outside Indiana and the vehicles carry Indiana plates, enter the tax district number(s) to receive excise tax credit:
______________________
______________________
______________________
______________________
Section G: Prepaid Sales Tax on Gasoline for Qualified Distributors (see instructions on page 3)
($100.00 Registration Fee)
Contact the Department at (317) 232-3524 for more information regarding this tax.
1. Enter your Indiana licensed gasoline distributor number:
2. Date of first gasoline sale:
3. Estimated number of gallons purchased/sold monthly:
4. Mailing name and address for prepaid sales tax returns (if different from Section A, Line 3):
Month
Day
Year
In care of:
Street Address:
City:
State:
Zip Code:
5. Name of contact person:
6. Contact Person’s Daytime Telephone Number:
EXT
(Please print legibly or type the information on this application.)
Business Tax Application
Page 4a
All retail merchants who are issued a permit to collect Prepaid Sales Tax on Gasoline
will be required to file monthly detailed reports (ST-103QD) with the Department.
A Prepaid Sales Tax Permit (BT-2) is not assignable and is valid only for the distributor in whose name it is issued.
Bonding Procedure
Concurrently with the filing of this application for a permit, a qualified distributor must file a bond with the Department. Below is the prescribed
formula for calculating the correct bond amount.
1.
Estimated average number of gallons supplied monthly from Section G, Line 3..........................
2.
Multiply Line 1 by .033 (Round to the nearest dollar amount)...................................................
3.
Estimated bond amount (multiply the amount on Line 2 by 3)....................................................
The amount on Line 3 is the amount of your bond, provided it is at least two thousand dollars ($2,000) which is the minimum bond amount. Indiana
Code 6-2.5-7-8 states that the Department shall determine the amount of the distributor's bond. Please use the most accurate figures available
to avoid a deficient bond. Please enclose Bond Form ST-160 or another form of surety and return it to the Department with this application.
In order to obtain a permit to collect Prepaid Sales Tax on Gasoline, the Indiana Department of Revenue requires that each refiner,
distributor or terminal operator agrees to make payment to the Department by means of "Electronic Funds Transfer" as defined in I.C.
4-8.1-2-7. An EFT authorization must be completed and returned to the Department. For further information regarding EFT filing,
and/or EFT authorization agreement contact the Department at (317) 232-5500.
Signature Section
Contact the Department at (317) 615-2700 for more information regarding this application.
I hereby certify that the statements are correct.
Signature: ______________________________________________________ Title: ___________________________________________
Date: ____________________________
This application must be signed by the owner, general partner, corporate officer, or resident agent before it will be accepted by the
Department. (I.C. 6-8.1-3-4)
NOTE: Failure to remit sales tax due and/or income tax withheld is a felony punishable by imprisonment, a fine of $10,000 plus a
100% fraud penalty.
The partners or corporate officers are each personally, jointly and severally liable for the sales and use tax* collected and the
withholding tax withheld. These taxes are trust fund taxes and are not discharged in bankruptcy proceedings.
*This includes:County Innkeepers Tax (CIT), Food and Beverage Tax (FAB), Prepaid Sales Tax, and Motor Vehicle Rental and County
Supplemental Excise Tax.
Upon completion of appropriate sections, sign, date
INDIANA DEPARTMENT OF REVENUE
and mail the application and fee(s) if applicable to:
SYSTEM SERVICES
P O BOX 6197
INDIANAPOLIS IN 46206-6197

Download Form BT-1 Business Tax Application - Indiana

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