Rev. 11/09
                                                                                            UT 1008
                             P.O. Box 182215                     07100100                   Application for Consumers 
                             Columbus, OH 43218-2215                                        Use Tax Registration
                             (888) 405-4089
                                                                                         Account no.
                                                                                    (For department use only)

    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. When did you begin or will you begin to make purchases subject to Ohio use tax?    
                                                                                                     (For the most current listings, search 
  3. Provide NAICS code and state nature of business activity                                       NAICS on our Web site at tax.ohio.gov.)
  
  4. Legal name 
          (Corporation, sole owner, partnership, etc.)

  5. Trade name or DBA

  6. Primary address
                             Address of corporation, sole owner, partnership, etc.  City State ZIP code

          Business phone no.                                     Fax no.                             Secondary phone no.

  7. Mailing address
                             (If different from above)                              City                     State           ZIP code
   
  8. How much use tax do you anticipate accruing each month?  Less than $5,000        $5,000 or greater       

  9. 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
  
 10. Name, phone number, fax number and e-mail address of individual the department should contact regarding this ac-
   count  

   Name                                                Phone no.                    Fax no.                  E-mail address

 Date                        Signature of applicant

                                                       Mail to address above.

    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.