Sales Tax Remittance Account Application For merchants who are required to remit sales tax to the Town of Gypsum. Business Activities (please note all activites conducted under this license) (required) Retail Sales Restaurant/Bar Lodging Professional Service Other Home Business (required) Yes No Internet Business (required) Yes No Type of Ownership (required) Sole Proprietor Partnership Corporation Other If Corporation, Registered Agent: Trade Name of Business (required) Name of Ownership (if other than trade name) Physical Address Street Number and Name (required) Unit Number (required) City (required) State/Province/Region (required) Postal/ZIP Code (required) Mailing Address Street Number and Name (required) Unit Number City (required) State/Province/Region (required) Postal/ZIP Code (required) Business Email (required) Business Phone (required) Are you registered with the Department of Revenue? (required) Yes No Sales Tax Filing Frequency (required) One Time Monthly Quarterly Annually Sales Tax Remittance Information Name of person preparing Sales tax Return (required) Full Name Business Phone (required) Choose One: (required) Employee Accountant/Bookeeper Other Email (required) By signing below, I declare, under penalty of perjury in the second degree, that this application has been examined by me. That the statements made herein are made in good faith pursuant to the Town of Gypsum's Municipal Code, and to the best of my knowledge and belief, are true, correct, and complete. I am attesting that the above listed business is in compliance with all the laws of the United States, State of Colorado, and the Town of Gypsum. Also, that this business or applicant is not in default of any financial obligation in any manner to the Town except current taxes. I also agree this business will comply with all laws and regulations applicable to such licensed business and avoid all practices or conditions which do or may affect the public health, morals, or welfare. As a corporation, in consideration of the issuance of the sales tax remittance account, I agree to be individually and personally liable for any sales tax owed to the Town of Gypsum, in addition to the liability of the corporation. Full Name (required) Title (required) Date and Time There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
