Department of                                                                    Rev. 12/09
             hio            Taxation                                                        ST 26
                                                                                            Application for 
                                                                07100100
                                                                                            Cumulative Return Authority
                                                                                    Vendor’s license no.
                                                                                    (For department use only)

Application is hereby made for cumulative return authority for those retail establishments listed on the next page.
It is agreed that if such authority is granted the applicant will fi le a tax return under the master vendor’s license in accordance 
with the prescribed method of fi ling as determined by the tax commissioner. The tax return will be supplemented by a detailed 
report of such data and information applicable to each individual retail establishment as the commissioner may require.

  Federal employer identifi cation no.                    Social Security no. / ITIN         Ohio corporate charter no. / certifi cate no.
   1.  Check type of ownership:  (10) Sole owner        (20) Partnership        (30) Corporation        (150) Nonprofi t           
    (50) LLC        (70) LLP        (80) LTD        Other (please specify)       
  
  2. Legal  name 
             (Corporation, sole owner, partnership, etc.)
  3. Trade name or DBA

  4. Primary address
                            Address of corporation, sole owner, partnership, etc.   City State ZIP code
                                                                                                                                      
             Business phone no.                                 Fax no.                              Secondary phone no.
  5. Mailing address
                            (If different from above)                               City                     State                    ZIP code
  6. If you operate as a corporation or partnership, list appropriate names, addresses and identifi cation numbers below.

  Title      Name                          Street               City                 State  ZIP code               SSN / ITIN / FEIN

  Title      Name                          Street               City                 State  ZIP code               SSN / ITIN / FEIN

  Title      Name                          Street               City                 State  ZIP code               SSN / ITIN / FEIN
  7. Name, phone number, fax number and e-mail address of individual the department should contact regarding this account

  Name                                                Phone no.                     Fax no.                  E-mail address

Date         Signature of applicant

                                                         Instructions
 List on the next page of this application, in numerical sequence,                 ter number on the line indicated on the license application.
 the license number and address of each retail establishment to                    Until you receive notifi cation of the effective date of the cumulative 
 be covered by master vendor’s license.                                            return authority, you will continue to fi le sales tax returns for each 
                                                                                   location under your present method of reporting.
 All licenses listed must be under the same entity number to be 
 eligible for cumulative return authority.                                         If one of your licenses is to be cancelled, the date of cancellation 
                                                                                   must be immediately forwarded to Registration Unit, P.O. Box 
 When a new license that will be reported under your cumulative                    182215, Columbus, OH  43218-2215. Phone: (888) 405-4089.
 authority is obtained from a county auditor, please write your mas-
  Mail to: Ohio Department of Taxation, Registration Unit, P.O. Box 182215, Columbus, OH  43218-2215.

                                                                                                  ST 26
                                                                                                  Rev. 12/09
                                                                                                  Page 2
The license numbers and addresses of each business location to be reported under the Cumulative Return Author-
ity must be listed in numerical sequence. Those business locations not yet licensed should also be listed indicating 
“applied for” in the license number column and the address in the address column.
License Number Street  Address                                                   City and ZIP Code

               Federal Privacy Act Notice
Because we require you to provide us with a Social Security number, the Federal Privacy Act of 
1974 requires us to inform you that providing us with your Social Security number is mandatory. 
Ohio Revised Code sections 5703.05, 5703.057 and 5747.08 authorize us to request this informa-
tion. We need your Social Security number in order to administer this tax.