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Get VT DoT BR-400 (Formerly S-1) 2020-2021

Has the Vermont Department of Taxes required a bond for this business entity or any business entity in which any person listed in Part 1 was an officer or held a 20 or more interest c No Rooms Tax license for this business entity or any business entity in which any person listed in Part 1 was an officer or held a 20 or more interest 3. Have you previously had a principal interest in a business with a Vermont Business Tax account If any answer in Part 3 is Yes please attach explanation. PART 5 - CERTIFICATION - All applicants must complete this section. I certify under pains and penalty of perjury this application is true correct and complete to the best of my knowledge. Send or fax completed application to Questions Contact us by Telephone 802 828-2551 option 3 Email tax. business vermont. gov Fax 802 828-5787 VT Schedule Business Principals with Fiscal Responsibility 1540A1200 Attach to Form BR-400 PRINCIPAL 1 SSN Address Title City Attach additional Schedule BR-400A if needed for additional business principals. Will you be paying wages salaries or commissions to Vermont residents working outside Vermont. Yes It is your responsibility to report any changes in your products or services which will affect your tax liability to the Vermont Department of Taxes in writing. PART 3 - PREVIOUS OWNERSHIP 1. Name of previous owner - Last Name 3. Address of previous owner 2. Date you purchased business mmddyyyy 4. State of Incorporation / / mm dd yyyy 16. Business Activity Check all that apply in Vermont Manufacturer Retail Construction Wholesale Hotel / Motel / Bed Breakfast Restaurant Service If married or civil union please complete Schedule BR-400A for additional owner/member. Form BR-400 formerly Form S-1 Page 1 of 3 Rev. 08/15 From Form BR-400 Part 1 Lines 2-4 Business Name FEIN Please consult the Instructions if you are unclear on what taxes you may be required to collect or remit. 1. Will your business be required to collect Sales and Use Tax. Yes No 4. Did you purchase an existing business or are you starting a new business. Business vermont. gov Fax 802 828-5787 VT Schedule Business Principals with Fiscal Responsibility 1540A1200 Attach to Form BR-400 PRINCIPAL 1 SSN Address Title City Attach additional Schedule BR-400A if needed for additional business principals. Schedule BR-400A Account Application If filing for more than one tax type or location file multiple copies of this form. Tax Type - Check ONE c Meals and Rooms MR c Sales and Use SU c Withholding WH complete Lines 1-3 and 7-10d 1. 1. Will your business be required to collect Sales and Use Tax. Yes No 4. Did you purchase an existing business or are you starting a new business. Purchased an existing business. Complete Part 3. 5. Is your business a distributor or wholesaler of cigarettes. Yes 7. Do you purchase tobacco products other than cigarettes from outside the State of Vermont. Yes Heating Oil Propane Kerosene Coal Natural Gas Yes Electricity 12. Purchased an existing business. Complete Part 3. 5. Is your business a distributor or wholesaler of cigarettes. Yes 7. Do you purchase tobacco products other than cigarettes from outside the State of Vermont. Yes Heating Oil Propane Kerosene Coal Natural Gas Yes Electricity 12. Will you be paying wages salaries or commissions to Vermont residents working outside Vermont. Yes It is your responsibility to report any changes in your products or services which will affect your tax liability to the Vermont Department of Taxes in writing..

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