Print Form Clear form Utah State Tax Commission 210 N 1950 W • SLC, UT 84134 • tax.utah.gov TC-69B Additional Business Locations Rev. 1/22 for a Sales Tax Account Do it all online: File and pay your taxes. Manage your account(s). 1 — General Information 1a. Social Security Number (SSN) Federal Employer Identification Number (EIN) (required for individual sole proprietor) (required for all entities other than sole proprietor) 1b. Existing Sales Tax Account Number (required for all accounts, if issued) STC 1c. Name of Legal Entity - PRINT If you are a sole proprietor, write your name here Daytime phone number Cell phone number Legal entity’s street address City County State Foreign country (if not U.S.) ZIP Code Legal entity’s mailing address City County State Foreign country (if not U.S.) ZIP Code Business website address (URL) Email address 1d. Certain Sales Activities Mark “yes” for each question below that applies to any of the outlets you are reporting: a. Will you have sales of grocery food? ...................................................................................... Yes No b. Will you sell motor vehicles, aircraft, watercraft, manufactured homes, modular homes or mobile homes in municipalities imposing the resort communities tax or the state correctional facility tax?.................................................................................................... Yes No c. Will you have retail sales of new tires? ..................................................................................... Yes No d. Are you a restaurant? ............................................................................................................... Yes No e. Will you offer rentals of motor vehicles (12,000 pounds or less) or off-road/recreational vehicles for 30 days or less?..................................................................................................... Yes No If yes, what type(s) of vehicles will you rent?................ Motor vehicles Off-road/recreational vehicles 2 — Additional/New Business Locations DBA/Business Name Business or trade name at this physical location Business start date for this location Physical street address of business (P.O. Box not acceptable) Business telephone number Office Use Only County City County State ZIP code City Code Required: Local Utah government issuing business license for this location SIC Code Business Description If business or product is different from main business location, describe here for this location USTC SIC NAICS Lodging Services: Will you provide motel, hotel, trailer court, campground or other lodging services at this location? Yes No a. G b. X c. W d. T e. F f. L Continued on next page |
Print Form Clear form TC-69B_2 DBA/Business Name Business or trade name at this physical location Business start date for this location Office Use Only Physical street address of business (P.O. Box not acceptable) Business telephone number County City County State ZIP code City Code Required: Local Utah government issuing business license for this location SIC Code Business Description If business or product is different from main business location, describe here for this location USTC SIC NAICS Lodging Services: Will you provide motel, hotel, trailer court, campground or other lodging services at this location? Yes No a. G b. X c. W d. T e. F f. L DBA/Business Name Business or trade name at this physical location Business start date for this location Office Use Only Physical street address of business (P.O. Box not acceptable) Business telephone number County City County State ZIP code City Code Required: Local Utah government issuing business license for this location SIC Code Business Description If business or product is different from main business location, describe here for this location USTC SIC NAICS Lodging Services: Will you provide motel, hotel, trailer court, campground or other lodging services at this location? Yes No a. G b. X c. W d. T e. F f. L 3 — Authorized Signature Signature of Authorized Applicant or Owner (Application will not be accepted without original signature) Date SIGN HERE Additional Business Locations for Sales Tax Accounts General Information Use this form to register additional business locations for a new or existing sales tax account. Do not use this form to register new cigarette, tobacco or e-cigarette outlets. Instead, use form TC-69. Instructions 1a. You must provide a valid Social Security Number or Federal Employer Identification Number. 1b. If you are already registered with the Tax Commission and you are adding locations to an existing sales tax account, you must also provide your Sales Tax Account Number. 1c. You must provide the legal entity's name, daytime phone number, cell phone number, street address (PO Box not acceptable), mailing address, website and email. 2. You must provide all information for each location: • DBA/business name • Business telephone number • Physical street address of business • City, County, State and Zip code • Local government issuing business license • Business description, if business or product is different than at the main business location 3. An authorized applicant or owner must sign this form. Return the completed form to the Tax Commission at the following address: Master Records Utah State Tax Commission 210 North 1950 West Salt Lake City, UT 84134-3310 Or fax to: 801-297-3573 |