Puerto Rico > Department Of Treasury
Application For Merchants Registration Certificate And Exemption Certificate AS 2914.1 - Puerto Rico
| Application For Merchants Registration Certificate And Exemption Certificate Form. This is a Puerto Rico form and can be used in Department Of Treasury . |
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Form AS 2914.1 Rev. Apr 9 08 APPLICATION FOR MERCHANT'S REGISTRATION CERTIFICATE AND EXEMPTION CERTIFICATE Serial Number PART I - INFORMATION OF MERCHANT'S PRINCIPAL OFFICE 1. Legal name of the corporation, partnership, individual owner (name, initial, last name) or other Receipt Stamp 2. Social security or employer identification number under which the income from this activity is informed on the income tax return (It is mandatory to complete this line) 3. Telephone Ext. 4. E-mail address 5. Postal address (Post Office Box, Urbanization or Building, Number or Apartment, Street) Municipality / City State Zip Code Country 6. Principal office's physical address (Urbanization or Building, Number or Apartment, Street) Municipality / City State Zip Code Country 7. Type of organization: Individual Estate or Trust Month Year Corporation or Partnership 9. Closing date of your accounting period: Day Month 8. Date of incorporation or creation: Day $ 10. Aggregate business volume at the end of the calendar year prior to the application (It shall be the sum of the business volume of all your locations): , , . 11. Amount of locations / activities included in this application: 12. Amount of Schedules included with this application: (It cannot be less than one) PART II - LOCATIONS / ACTIVITIES Indicate the information for each one of the locations operated by the business (submit Schedule AS 2914.1 if necessary). - * - You shall complete all lines of this part in order to process the application. - * 13. Trade name or "DBA" 14. Type of registration certificate requested (Check one): If you checked Temtorary Business or Exhibitor, indicate:(From: Day 15. Will you sell tangible personal property? Yes Merchant Month No 16. Telephone Mobile business Year Temporary business To: Day Month Exhibitor Year ) Ext. . 17. Physical address (Urbanization or Building, Number or Apartment, Street). If it is the same as the one indicated on line 6, check here and continue on line 18 Municipality / City State Zip Code Country Retention: Six (6) years. American LegalNet, Inc. www.FormsWorkflow.com Form AS 2914.1 Rev. Apr 9 08 Page 2 CONTINUED PART II (LOCATIONS / ACTIVITIES) 18. Description of the activity 20. Beginning date of operations: 19. North American Industry Day Month Year Classification System(NAICS) 21. Indicate if you are requesting an exemption certificate: Yes No 22. If you answered "Yes" on line 21, indicate the reason for requesting an exemption certificate: Manufacturing plant Reseller $ 23. Business volume at the end of the calendar year prior to the application: , , . PART III - PERSONS HAVING INTEREST IN THE BUSINESS 24. Indicate the information for each owner, partner, shareholder or any other person owning 50% or more interest in the business: Ownership percentage Social security or employer identification number Yes No. If "Yes", indicate the following information for the other business: Social security or employer identification number Ownership percentage Social security or employer identification number Yes No. If "Yes", indicate the following information for the other business: Social security or employer identification number 24a. Name Title If your business provides services, do you own 50% or more interest in another business? Name 24b. Name Title If your business pvovides services, do you own 50% or more interest in another business? Name OATH I hereby declare under penalties of perjury that this application has been examined by me, and that to the best of my knowledge and belief, all the information provided herein is true, correct and complete. I also agree to notify the Secretary of the Treasury of any change in the information provided on this application, within 30 days of the change or event. The declaration of the person that prepares this application (except the merchant) is with respect to the available information, and such information has been verified. Merchant's name Title Name of duly authorized agent Social security or employer identification number Merchant's signature Date Signature of duly authorized agent Address Date Telephone TO BE COMPLETED BY THE DEPARTMENT OF THE TREASURY Employee's name District Retention: Six (6) years. After evaluating this application, I certify that it is complete in all of its parts and that the information provided herein is presumed to be true. Nevertheless, the Department of the Treasury reserves the right to conduct any future investigation to verify the information. Employee's signature Date Confirmation number American LegalNet, Inc. www.FormsWorkflow.com Schedule AS 2914.1 Rev. Apr 9 08 LOCATIONS Legal name of the corporation, partnership, individual owner (name, initial, last name) or other Use this Schedule if you own more locations than the spaces provided in Part II of the Application for Merchant's Registration Certificate and Exemption Certificate (Form AS 2914.1). 1. Trade name or "DBA" 2. Type of registration certificate requested (Check one): If you checked Temporary Business or Exhibitor, indicate: (From:Day 3. Will you sell tangible personal property? Yes Merchant Month No 4. Telephone Mobile business Year Temporary business To:Day Month Ext. Exhibitor Year ) 5. Physical address (Urbanization or Building, Number or Apartment, Street) Municipality / City State Zip Code Country 6. Description of the activity 7. North American Industry 8. Beginning date of operations: Classification System (NAICS) Day Month Year 9. Indicate if you are requesting an exemption certificate: Yes No 10. If you answered "Yes" on ine 9, indicate the reason for requesting an exemption certificate: Manufacturing plant Reseller $ , , . 11. Business volume at the end of the calendar year prior to the application: 1. Trade name or "DBA" 2. Type of registration certificate requested (Check one): If you checked Temporary Business or Exhibitor, indicate: (From:Day 3. Will you sell tangible personal property? Yes Merchant Month No 4. Telephone Mobile business Year Temporary business To:Day Month Exhibitor Year Ext. ) 5. Physical address (Urbanization or Building, Number or Apartment, Street) Municipality / City State Zip Code Country 6. Description of the activity 7. North American Industry 8. Beginning date of operations: Classification System (NAICS) Day Month Year 9. Indicate if you are requesting an exemption certificate: Yes No 10. If you answered "Yes" on ine 9, indicate the reason for requesting an exemption certificate: Manufacturing plant Re
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