Business and Professional Questionnaire

Any business with income derived from or earned within the city of Coshocton is subject to the 1.5% tax on their net profit.

Any employer located inside or any employer outside of the city of Coshocton with employees working in Coshocton are required to withhold, and remit to the city of Coshocton, 1.5% of the gross wages of employees if they are working in the city more than 12 calendar days in any year. Anyone working in the JEDD areas is considered working in the city limits.

1. Trade name of business:

If you are already filing this income under another account please provide your SS# or Federal ID# so we can update our records.

2. Local Address:


Local Phone Number:

Do you conduct your business from any other location within Coshocton?
Yes | No
If so, list address(es) Please give the exact address of the job site(s)


List any other businesses you operate located in Coshocton

3. Is above location Main or Branch?
Main | Branch

If branch give name and address of main office.
Name
Address
City State & Zipcode
Phone number

4. Nature of business conducted:

5. Date started (or acquired) in Coshocton:

6. Name and address of previous owner (if any):

7. Accounting period used for Federal Income Tax purposes. Check which apply
Calendar year ending (12-31): | Fiscal year ending:

8. Type of ownership. Check which apply
Sole Proprietorship. Name of owner
Give your residence address, city, state and zip code

Corporation. Give your Federal ID #
Give name and address of parent company main office

Partnership. Give your Federal ID #

Non-profit Corporation. Give your Federal ID #

9. If partnership, indicate how the city of Coshocton Income Tax Return will be filed and paid:
In full by business
Separately by the individual partners on proportionate shares

10. Do you employ one or more persons working in the city of Coshocton? (Past or present)
Yes | No

If you do not employ anyone now, do you expect to do so in the coming year?
Yes | No

11. Do you pay independent or sub-contractors for service performed in Coshocton?
Yes | No

If so and you are not withholding Coshocton tax from these contractors, include a list showing names and addresses of those contractors. These people have a tax liability to the city of Coshocton.

12. If you are a contractor or sub-contractor list the names of the project(s) you are or have worked on in Coshocton and approximate dates

You are responsible for your employee's withholding tax.

13. Do you own rental property in Coshocton?
Yes | No

If so, list addresses and whether property is multi-family, residential, or commercial.

14. With reference to rental properties (land and buildings) located within the city of Coshocton, does your business occupy, as a tenant, real property in Coshocton you rent from others?
Yes | No

If so, to whom is rent paid?

15. If location of business is outside Coshocton, do you have earnings from activity in Coshocton?
Yes | No

16. Please complete the way you want your forms to be addressed:
Send Business Net Profit Return Forms to:
Name:
Address: City:
State: Zip code:

Send Withholding Tax Return Forms to:
Name:
Address: City:
State: Zip code:

17. The information hereby submitted is true and correct. Type your full name and title below.
Signature: Title: