10A100 Form – Fill Out and Use This PDF

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In order to file your 10A100 form, you will need the following information: the name of your business, your federal employer identification number (EIN), and your social security number (SSN). The 10A100 form is used to report wages paid to employees and supplemental unemployment benefits (SUB) payments. You must file this form each year, even if you did not pay any wages or SUB payments. By filing this form, you will help ensure that the IRS has accurate records of wages paid and taxes withheld. For more information on the 10A100 form, please consult the instructions provided by the IRS.

Question	Answer
Form Name	10A100 Form
Form Length	29 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	7 min 15 sec
Other names	kentucky tax registration application, 10a100 kentucky form, 10a100 form ky, kentucky 10a100

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COMMONWEALTH OF KENTUCKY

DEPARTMENT OF REVENUE

FRANKFORT, KENTUCKY 40620

10A100(P) (8-12)

Kentucky Tax Registration Application

and Instructions

www.revenue.ky.gov

Employer’s Withholding Tax Account

Sales and Use Tax Account/Permit

Transient Room Tax Account

Motor Vehicle Tire Fee Account

Telecommunications Tax Account

Utility Gross Receipts License Tax Account

Consumer’s Use Tax Account

Coal Severance and Processing Tax Account

Coal Seller/Purchaser Certiﬁcate ID Number

Corporation Income Tax Account

Limited Liability Entity Tax Account

10A100 (8-12)

Commonwealth of Kentucky

DEPARTMENT OF REVENUE

KENTUCKY TAX REGISTRATION APPLICATION

NOTE: For your convenience, application may be ﬁled online at http://onestop.ky.gov.

•Incomplete or illegible applications will delay processing and will be returned.

•Print or type the application using blue or black ink only.

•Please see instructions for questions regarding completion of the application.

•Need Help? Call (502) 564-3306 or visit www.revenue.ky.gov

FOR OFFICE USE ONLY

 WH  SU	 TEL	 CU  CP		 CT
 TR	 UTL		 LL	 CID
 TF

CRIS #

CTS CASE #			Coded

CTS Person ID #			Date Coded

RCS Flag			Data Entry

NAICS	SIC		Date Data Entered

SECTION A

REASON FOR COMPLETING THIS APPLICATION (Must Be Completed)

1. Effective Date

2. Previous Account Numbers (If Applicable)

 Opened new business/Began activity in Kentucky

Kentucky Employer’s Withholding Tax

__________________

 Resumption of business

Kentucky Sales and Use Tax

__________________

 Hired employees working in Kentucky

Kentucky Telecommunications Tax

__________________

 Hired employees working outside KY who have a KY residence

Kentucky Utilities Gross Receipts License Tax

__________________

 Applying for other accounts/Began a new taxable activity

Kentucky Consumer’s Use Tax

__________________

 Bidding for State Government Contract (State Vendor or Afﬁliates)

Kentucky Corporation Income Tax and/or

 Purchased an existing business (See Instructions)

Limited Liability Entity Tax

__________________

 Ownership/Entity type change or conversion

Kentucky Coal Severance & Processing Tax

__________________

(Specify previous type; See Instructions)

Federal ID Number (FEIN)

__________________

Kentucky Secretary of State Organization Number

__________________

Change in Federal Identiﬁcation Number (FEIN) or Kentucky Secretary of State Organization Number

To update information for your existing account(s) or report

 Other (Specify)opening a new location of your current business, use

Form 10A104, Update or Cancellation of Kentucky Tax Account(s).

SECTION B

BUSINESS / RESPONSIBLE PARTY / CONTACT INFORMATION (Must Be Completed)

3.Legal Business Name

4.Doing Business As (See Instructions)

5.Federal Employer Identiﬁcation Number (FEIN)

(Required, complete prior to submitting)

6.Secretary of State Information (if applicable)

—

Kentucky Secretary of State Organization Number

Date of Incorporation/Organization

/ /

State of Incorporation/Organization

If an Out-of-state Entity, Date of Qualiﬁcation with the Kentucky Secretary of State’s Ofﬁce

/ /

Business Location

8. Location of Business Records

Use the same address as listed in Question 7

Street Address (DO NOT List a PO Box)

City

State

Zip Code

City

State

Zip Code

Telephone Number

County (if in Kentucky)

Telephone Number

County (if in Kentucky)

(

)

–

(

)

–

Accounting Period

 Calendar Year: Year Ending December 31st

 Fiscal Year: Year Ending ___ ___ /___ ___ (mm/dd)

52/53 Week Calendar Year: December __________  52/53 Week Fiscal Year: _______________________________

(Day of Week that year ends)

(Month & Day of Week that year ends)

10A100 (8-12)

10. Ownership Type

 Sole Proprietorship	 Corporation
 General Partnership	 Association
 Joint Venture	 Cooperative
 Estate	 Limited Cooperative Association
 Government	 Statutory Trust
 Unincorporated	 Series of a Statutory Trust
Non-proﬁt	 Trust (non-statutory)
	 Trust (non-statutory)
 Professional Service
Corporation (PSC)

Page 2

Limited Partnership (LP or PLP)  Limited Liability Company (LLC or PLLC)

	 Limited Liability Partnership	 Series of a Limited Liability Company
	(LLP or PLLP)	 Protected Cell Company (PCC)
		 Protected Cell Company (PCC)
	 Limited Liability Limited Partnership	 Cell of a Protected Cell Company
	(LLLP or PLLLP)	 Other (Specify)
	 Series of a Partnership	 Other (Specify)
	 Series of a Partnership

11. How Will You be Taxed for Federal Purposes? (Sole Proprietorships, Estates, and Governments SKIP question 11)

 Partnership	 Cooperative
 Corporation	 Real Estate Investment Trust (REIT)
 S-Corporation	 Regulated Investment Company (RIC)
 Non-Proﬁt	 Real Estate Mortgage Investment
 Homeowner’s Association	Conduit (REMIC)
 Homeowner’s Association
	 Trust

Single Member Disregarded Entity

Check below how the Member will be taxed Federally

Individual Sole Proprietorship

General Partnership/Joint Venture

Estate

Trust (non-statutory)

Other (Specify how the member is federally taxed)

12–13. OWNERSHIP DISCLOSURE–RESPONSIBLE PARTIES (REQUIRED FOR ALL OWNERSHIP TYPES)

Full Legal Name (Last, First, Middle)

Social Security Number (REQUIRED)

KY Driver’s License Number (if applicable)

Social Security Number (REQUIRED)

KY Driver’s License Number (if applicable)

Business Title

Effective Date of Title

Business Title

Effective Date of Title

Residence Address

City

State

Zip Code

City

State

Zip Code

Telephone Number

County (if in Kentucky)

Telephone Number

County (if in Kentucky)

(

)

–

(

)

–

14. Person to contact about this application:

Name (Last, First, Middle)		Title	Daytime Telephone			Extension

			(	)	–

E-mail: (By supplying your e-mail address you grant the Department
of Revenue permission to contact you via e-mail.)


SECTION C	TELL US ABOUT YOUR BUSINESS OR ORGANIZATION (Must Be Completed)

15.A. Describe the nature of your business activity in Kentucky, including any services provided.

________________________________________________________________________________________________________

B.If you make sales in Kentucky, list the products sold. ___________________________________________________________

C.Describe the nature of your business activity outside Kentucky, including any services provided.

________________________________________________________________________________________________________

16.Do you have or will you hire employees to work in Kentucky within the next 6 months?......................................................................

(An employee is anyone to whom you pay wages, including part-time help and family members.)

17.Do you wish to voluntarily withhold on Kentucky residents who work outside Kentucky or withhold on pension and

retirement payments? ....................................................................................................................................................................................

18.If your business is a corporation or limited liability company choosing taxation as a corporation for Federal purposes,

will the Kentucky ofﬁcers receive compensation other than dividends?.................................................................................................

If you answered “YES” to ANY of questions 16 through 18, you must complete SECTION D.

Yes No



 Ð



10A100 (8-12)			Page 3
		Yes	No
19.	Will you make retail and/or wholesale sales of tangible personal property or digital property in Kentucky?		
	(Examples: prepared food, internet sales, downloaded music and books. See Instructions for more.)
20.	Will you repair, install replacement parts, produce, fabricate, process, print or imprint tangible personal property?		
	(Examples: automotive repairs and window tinting, sign making, embroidery, and engraving. See Instructions for more.)
21.	Will you rent/lease tangible personal property to others, including related companies?		
22.	Will you charge taxable admissions?		
23.	Will you rent temporary lodging to others?		
24.	Will you sell for or are you a manufacturer’s agent soliciting orders for a nonresident seller not registered in Kentucky?		
25.	Will you receive receipts from the breeding of a stallion to a mare in Kentucky?		
26.	Will you make sales of motor vehicles to residents of AZ, CA, FL, IN, MA, MI, SC, or WA?		
27.	Will you make sales of aviation/jet fuel?		
28.	Are you a manufacturing fee processor or a contract miner located in Kentucky?		
29.	Will you sell any of the following?

Yes	No		Yes	No
		A. Coal or other minerals			E.	Sewer services
		B. Water utilities			F.	Communication services
		C. Natural, artiﬁcal, or mixed gas			G.	Multichannel video programming services
						*(see Instructions)

 D. Electricity

If you answered “YES” to ANY of questions 19 through 29 (except 29 G), you must complete SECTION E and you may SKIP questions 30-31.

If you answered “YES” to ANY of questions 29 B through 29 G, you must ALSO complete SECTION F.

		Yes	No	Ð
30.	Are you a construction company/contractor that will bring into this state construction materials or supplies on which
	no Kentucky sales tax or equivalent has been paid?		
31.	Will you make purchases from out-of-state vendors and not pay Kentucky sales or use tax to the seller on those
31.	purchases? (IF YOU ARE A PROFESSIONAL SERVICE BUSINESS, PLEASE SEE INSTRUCTIONS FOR IMPORTANT		
	ADDITIONAL DETAILS.)		
	If you answered “YES” to EITHER of questions 30 or 31, you must complete SECTION G.			Ð
		Yes	No
32.	Will you mine coal that you own or possess the mineral rights to, either by deed, lease, consent, etc.?		
33.	Does your company perform one or more of the following activities:
	A. Purchase coal for the purpose of processing and resale?		
	B. Process refuse coal?		
	(Processing means cleaning, breaking, sizing, dust allaying, treating to prevent freezing, or loading or unloading for any purpose.)
	C. Purchase and sell coal as a coal broker?		
	If you answered “YES” to ANY of questions 32 or 33, you must complete SECTION H and SECTION E.
		Yes	No
34.	Is your business/organization a corporation, S corporation, professional service corporation (PSC), association, homeowner’s		 Ð
	association, cooperative, limited cooperative association, statutory trust, series of a statutory trust, limited partnership (LP or
	PLP), limited liability partnership (LLP or PLLP), limited liability limited partnership (LLLP or PLLLP), series of a partnership,
	limited liability company (LLC or PLLC), series of a limited liability company, real estate investment trust (REIT), regulated
	investment company (RIC), real estate mortgage investment conduit (REMIC), protected cell company (PCC), cell of a protected
	cell company, or similar entity created with limited liability for the partners, members or shareholders?	
	If you answered “YES” to question 34, you MUST answer questions 35 through 42.			Ð
	Sole Proprietorships and General Partnerships should SKIP questions 35 through 42.
		Yes	No
35.	Is your corporation incorporated or limited liability entity organized under the laws of Kentucky with the Kentucky Secretary of
	State’s Ofﬁce?		
36.	Will your corporation/limited liability entity have its commercial domicile in Kentucky?		
37.	Will your corporation/limited liability entity own/lease any real or tangible personal property located in Kentucky?		
38.	Will your corporation/limited liability entity have one or more individuals performing services in Kentucky?		
39.	Will your corporation/limited liability entity maintain an interest in a pass-through entity doing business in Kentucky?		

10A100 (8-12)			Page 4
40.	Will your corporation/limited liability entity derive income from, or attributable to, sources within Kentucky, including
	income derived directly/indirectly from a trust/single member limited liability company doing business in Kentucky?		
41.	Will your corporation/limited liability entity direct activities at Kentucky customers for the purpose of selling them goods
	or services?		

42.Will your corporation/limited liability entity own/lease any intangible property or receive payments from a related member as deﬁned in KRS 141.205(1)(g) or an unrelated party for the use of intangible property in Kentucky such as royalties,

franchise agreements, patents, trademarks, etc.?



If you answered “YES” to ANY of questions 35 through 42, you MUST complete SECTION I.

SECTION D

EMPLOYER’S WITHHOLDING TAX ACCOUNT

Must be completed if you answered “YES” to ANY of the questions 16 through 18.

43.

Has a Kentucky Employer’s Withholding Tax Account already been assigned to this business?  Yes

 No

If yes, list the Employer’s Withholding Tax Account Number

44.

Number of Kentucky employees ______________________________

47.

Employer’s Withholding Tax returns should be mailed to:

45.

Date wages/pensions ﬁrst paid or will be paid (REQUIRED)

 Use the same address as listed on Page 1, Section B, Question 7

c/o or Attn.

Address

46.

Estimated total annual tax withheld in Kentucky:

 $0.00–$399.99

 $2,000.00–$49,999.99

City

State

Zip Code

 $400.00–$1,999.99

 $50,000.00 or more

Mailing Telephone Number

County (if in Kentucky)

(

)

–

SECTION E

SALES AND USE TAX ACCOUNT

TRANSIENT ROOM TAX ACCOUNT AND MOTOR VEHICLE TIRE FEE ACCOUNT

Must be completed if you answered “YES” to ANY of the questions 19 through 29 (except 29 G) or question 32 or 33.

48. A.

Has a Kentucky Sales and Use Tax Account already been assigned to this business?  Yes

 No

If yes, list the Sales and Use Tax Account Number

49. Date sales began or will begin (REQUIRED)

 Cash

 Accrual

50.

Accounting Method

51.

Do you rent temporary lodging to others?

 Yes

 No

52.

Do you sell new tires for motor vehicles?

 Yes

 No

53.

Estimated gross monthly sales tax collected in Kentucky:

 $0.00–$1,199.99

 $1,200.00 or more

54.Sales and Use Tax returns should be mailed to:

 Use the same address as listed on Page 1, Section B, Question 7

c/o or Attn.

Address

City			State	Zip Code

Mailing Telephone Number			County (if in Kentucky)
(	)	–

SECTION F TELECOMMUNICATIONS TAX ACCOUNT AND/OR UTILITY GROSS RECEIPTS LICENSE TAX ACCOUNT

Must be completed if you answered “YES” to ANY questions 29B through 29G.

55.

Has a Kentucky Telecommunications and/or Utility Gross Receipts License Tax Account already been assigned to this business?  Yes

 No

If yes, list the Telecommunications Tax Account Number

If yes, list the Utility Gross Receipts License Tax Account Number

56.

Date sales of communications or utilities began or will begin

(REQUIRED)

Once the account for Telecommunications Tax is assigned, use the following

website to set up account for online ﬁling of returns.

http://revenue.ky.gov/business/Telecom.htm

57.

Telephone Number

Once the account for Utility Gross Receipts License Tax is assigned, use the

following website to set up account for online ﬁling of returns.

(__________) __________ – ____________________

http://revenue.ky.gov/business/utilschool.htm

10A100 (8-12)

Page 5

WH #

CT #

FOR OFFICE USE ONLY

SU # / TR # / TF #

TELECOM #

UGRLT #

USE #

CP/LLET #

CID #

SECTION G

CONSUMER’S USE TAX ACCOUNT

Must be completed if you answered “YES” to EITHER question 30 or 31.

58.

Has a Consumer’s Use Tax Account already been assigned to this business?  Yes  No

If yes, list the Consumer’s Use Tax Account Number

59.

Date purchases began or will begin (REQUIRED)

60. Consumer’s Use Tax returns should be mailed to:

 Use the same address as listed on Page 1, Section B, Question 7

* If you make a one-time purchase only, see the Instructions

c/o or Attn.

Address

City

State

Zip Code

Mailing Telephone Number

County (if in Kentucky)

(

)

–

SECTION H COAL SEVERANCE/PROCESSING TAX ACCOUNT and/or COAL SELLER/PURCHASER CERTIFICATE ID #

Must be completed if you answered “YES” to EITHER question 32 or 33.

61. A.

Has a Coal Severance Tax Account and/or Coal Seller/Purchaser Certiﬁcate ID # already been assigned to this business?  Yes

 No

If yes, list the Coal Severance Tax Account Number

If yes, list the Coal Seller/Purchaser Certiﬁcate ID Number

62.Date mining/processing or coal brokering operations began or will begin (REQUIRED)

63.Coal Severance & Processing Tax returns should be mailed to:

 Use the same address as listed on Page 1, Section B, Question 7

c/o or Attn.

Address

10A100 (8-12)

Page 6

SECTION I

CORPORATION INCOME AND/OR LIMITED LIABILITY ENTITY TAX ACCOUNT

Must be completed if you answered “YES” to ANY of questions 35 through 42.

64.

Has a Corporation Income and/or Limited Liability Entity Tax Account already been assigned to this business?

 Yes

 No

If yes, list the Corporation Income or Limited Liability Entity Tax Account Number

65.

Is your entity exempt from Corporation Income Tax or Limited Liability Entity Tax under Kentucky law?

 Yes

 No

B.If yes, select the exemption type below:

Financial institution, as deﬁned in KRS 136.500, except banker’s banks organized under KRS 287.135 or KRS 286.3-135

Savings and loan association organized under the laws of this state and under the laws of the United States and making loans to members only

Bank for cooperatives

Production credit association

Insurance company, including farmers’ or other mutual hail, cyclone, windstorm, or ﬁre insurance companies, insurers, and reciprocal underwriters (does not include insurance agencies)

Corporation or other entity exempt under Section 501 of the Internal Revenue Code

Religious, educational, charitable, or like corporation not organized or conducted for pecuniary proﬁt

Corporation whose only owned or leased property located in this state is located at the premises of a printer with which it has contracted for printing, provided that: 1. The property consists of the ﬁnal printed product, or copy from which the printed product is produced; and 2. The corporation has no individuals receiving compensation in this state as provided in KRS 141.120(8)(b)

Public service corporation subject to tax under KRS 136.120

Open-end registered investment company organized under the laws of this state and registered under the Investment Company Act of 1940

Any property or facility which has been certiﬁed as a ﬂuidized bed energy production facility as deﬁned in KRS 211.390

An alcohol production facility as deﬁned in KRS 247.910

Real estate investment trust (REIT) as deﬁned in Section 856 of the Internal Revenue Code

Regulated investment company (RIC) as deﬁned in Section 851 of the Internal Revenue Code

Real estate mortgage investment conduit (REMIC) as deﬁned in Section 860D of the Internal Revenue Code

Personal service corporation as deﬁned in Section 269A(b)(1) of the Internal Revenue Code

Publicly traded partnership as deﬁned by Section 7704(b) of the Internal Revenue Code that is treated as a partnership for federal tax purposes under Section 7704(c) of the Internal Revenue Code, or their publicly traded partnership afﬁliates. (Publicly traded partnership afﬁliates shall include any limited liability company or limited partnership for which at least eighty percent (80%) of the limited liability company member interests or limited partner interests are owned directly or indirectly by the publicly traded partnership.)

Qualiﬁed investment partnership (QIP) as deﬁned in KRS 141.206(15)(a) &(b)

Statutory trust or series of a statutory trust

Cooperative described in Sections 521 and 1381 of the Internal Revenue Code (Select category below)

Farmers’ agricultural and other cooperatives organized or recognized under KRS Chapter 272

Advertising cooperatives

Purchasing cooperatives

Homeowner’s associations including those described in Section 528 of the Internal Revenue Code

Political organizations as deﬁned in Section 527 of the Internal Revenue Code

Rural electric and rural telephone cooperatives

C. If Political Organization selected above, are you required to ﬁle Federal Form 1120-POL?  Yes

 No

66. A. Is this entity treated Federally as a division of a parent company

and not separately taxed as its own entity?  Yes

 No

B.If yes, select the division type below:

Qualiﬁed Subchapter S-corporation Subsidiary (QSS)

Qualiﬁed Real Estate Investment Trust Subsidiary (QREIT)

Captive Real Estate Investment Trust (REIT) as deﬁned in KRS 141.010(29)

67.If an out-of-state entity, is your Kentucky activity limited to the mere solicitation

of the sale of tangible personal property?  Yes

 No

68.If an out-of-state entity, date that activity or receipt of pass through income began or will begin in Kentucky

69.Corporation Income and/or Limited Liability Entity Tax correspondence should be mailed to:

 Use the same address as listed on Page 1, Section B, Question 7

c/o or Attn.

Address

10A100 (8-12)

Page 7

IMPORTANT: THIS APPLICATION MUST BE SIGNED BELOW:

The statements contained in this application and any accompanying schedules are hereby certiﬁed to be correct to the best knowledge and belief of the undersigned who is duly authorized to sign this application.

Signed: ___________________________________________________________	Signed: ___________________________________________________________
Phone Number: _____________________________________________________	Phone Number: _____________________________________________________
Title: __________________________ Date: ____/____/______(mm/dd/yyyy)	Title: _________________________	Date: ____/____/______(mm/dd/yyyy)

For assistance in completing the application, please call the Taxpayer Registration Section at (502) 564-3306, Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m., Eastern Time, or you may contact one of the Kentucky Taxpayer Service Centers or use the Telecommunications Device for the Deaf. Each ofﬁce is open Monday through Friday, 8:00 a.m. to 5:00 p.m., local time. For a list of Taxpayer Service Centers and phone numbers, see the Instructions.

MAIL completed application to:KENTUCKY DEPARTMENT OF REVENUEorFAX to: 502-227-0772 P.O. BOX 299, STATION 20

FRANKFORT, KENTUCKY 40602-0299

See Form 10A100-I, Instructions for Kentucky Tax Registration Application, for step-by-step instructions and additional information in completing this application.

If you are applying for a withholding account and/or a sales and use tax account and would like to register for Electronic Funds Transfer (EFT), visit the Kentucky Department of Revenue website at www.revenue.ky.gov.

To register for cigarette tax, minerals or natural gas severance tax, motor fuels tax, or any other miscellaneous taxes or fees administered by the Department of Revenue, please visit the Department’s website at www.revenue.ky.gov.

This form does not include registration with the Secretary of State, Unemployment Insurance, or Workers’ Compensation Insurance. For assistance, please contact those ofﬁces at the numbers below.

Secretary of State	(502) 564-3490	Unemployment Insurance	(502) 564-2272	Workers’ Compensation	(502) 564-5550
IRS--FEIN	(800) 829-4933

For assistance with other questions about starting a business in Kentucky, including special licensing and permitting requirements, business structure registration, employer responsibilities, and business development resources, call the Business Information Clearinghouse at 1-800-626-2250 or visit the Kentucky Business One Stop website at http://onestop.ky.gov.

The Kentucky Department of Revenue does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.

10A100-I (8-12)

Commonwealth of Kentucky

INSTRUCTIONS

DEPARTMENT OF REVENUE

KENTUCKY TAX REGISTRATION APPLICATION

WHAT IS THE PURPOSE OF THE KENTUCKY TAX REGISTRATION APPLICATION?

This application is used to apply for any of the following: Employer’s Withholding Tax Account, Sales and Use Tax Account/Permit,Transient Room Tax Account, Motor Vehicle Tire Fee Account, Telecommunications Tax Account, Utility Gross Receipts License Tax Account, Consumer’s Use Tax Account, Coal Severance and Processing Tax Account, Coal Seller/Purchaser Certiﬁcate ID Number, Corporation Income Tax Account, or Limited Liability Entity Tax Account.

DO I HAVE ANY OTHER STATE TAX REGISTRATION REQUIREMENTS?

Depending on the product or service your business provides, there may be other state taxes that apply to your business. Most of these require that you ﬁle a special application/registration. Refer to Page 7 of the application for information about other applicable registrations.

I ALREADY HAVE TAX ACCOUNTS, HOW DO I UPDATE MY ACCOUNT INFORMATION?

You must complete FORM 10A104, UPDATE OR CANCELLATION OF KENTUCKY TAX ACCOUNT(S), to update information such as business name, location or mailing addresses, phone numbers, accounting period, responsible party information, and to report a taxing election change with the IRS or to request cancellation of your accounts.

WHO CAN I CALL WITH QUESTIONS ABOUT REGISTRATION?

For help completing the application, please call the Taxpayer Registration Section at (502) 564-3306, Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m., Eastern Time.

You may also contact one of the following Kentucky Taxpayer Service Centers or the Telecommunications Device for the Deaf. Each ofﬁce is open Monday through Friday, 8:00 a.m. to 5:00 p.m., local time.

Ashland	(606) 920-2037	Hopkinsville	(270) 889-6521	Paducah	(270) 575-7148
Bowling Green	(270) 746-7470	Louisville	(502) 595-4512	Pikeville	(606) 433-7675
Central Kentucky	(502) 564-5930	Northern Kentucky	(859) 371-9049	Telecommunication Device	(502) 564-3058
Corbin	(606) 528-3322	Owensboro	(270) 687-7301	for the Deaf

The Department of Revenue has an Ombudsman to serve as your advocate and is available to make sure your rights are protected. You may contact the Ombudsman at (502) 564-7822.

WHEN SHOULD I FILE MY APPLICATION?

You are required to complete the application and ﬁle it with the Kentucky Department of Revenue, at least 30 days before engaging in an activity that requires the establishment of the following:

n Employer’s Withholding Tax Account (KRS 141.310)		n Utility Gross Receipts License Tax Account (KRS 160.613)
n Sales and Use Tax Account (KRS 139.200, 139.240)		n Telecommunications Tax Account (KRS 136.604 and 136.616)
n	Transient Room Tax Account (KRS 142.400)	n	Coal Severance and Processing Tax Account (KRS 143.020)
n	Motor Vehicle Tire Fee Account (KRS 224.50-868)	n	Coal Seller/Purchaser Certiﬁcate ID Number (KRS 143.037)

nConsumer’s Use Tax Account (KRS 139.310)

Corporations and Limited Liability Entities must complete the application to establish a Corporation Income Tax Account and/or a Limited Liability Entity Tax Account (KRS 141.040, 141.0401):

If you are...	Then your application should be ﬁled...

Kentucky formed	Within 30 days of formation with the Kentucky Secretary of State’s Ofﬁce.

Formed out-of-state and you have obtained a Certiﬁcate of Authority to	Within 30 days of obtaining a certiﬁcate of authority, provided that you
transact business in Kentucky from the Kentucky Secretary of State.	are treated as doing business in Kentucky under KRS chapter 141.

Formed out-of-state and you have NOT obtained a Certiﬁcate of Authority	Within 30 days of ﬁrst engaging in activities that result in you being
to transact business in Kentucky from the Kentucky Secretary of State.	treated as doing business in Kentucky under KRS chapter 141.

IS MY APPLICATION COMPLETE?

Your application will not be considered complete unless it includes all required information speciﬁed on the Form. This includes, but is not limited to, a Federal Employer Identiﬁcation Number and accurate Social Security Number(s), as appropriate.

WHAT PENALTIES APPLY?

Failure to complete and ﬁle the required application in the speciﬁed time frames listed above shall subject you to penalties under KRS 131.180.

HOW LONG WILL IT TAKE FOR MY ACCOUNT NUMBERS TO BE ASSIGNED?

Fully completed paper applications will be processed, barring seasonal workload increases, within 5 to 10 business days. Applications with missing or unclear information, requiring additional research, may take longer. Those with extensive amounts of missing information will be returned by mail for further completion.

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LINE BY LINE APPLICATION INSTRUCTIONS

SECTION A—REASON FOR COMPLETING THIS APPLICATION

1.Effective Date—Enter the effective date of the reason you are completing this application. Check the box which corresponds to why the application is being completed.

•฀ Opened New Business, Began activity in Kentucky, Resumption of Business, Hired employees working in Kentucky, Hired employees working outside Kentucky who have a Kentucky residence—Complete Sections A, B, and C, to determine the accounts for which you are required to apply. For Resumption of Business, list your previous account numbers in Section A, question 2.

•฀ Applying for Other Accounts, Began a new Taxable Activity—If you require an account type that is not currently assigned to your business, complete Sections B and C to determine the additional accounts for which you are required to apply. If the questions in Section C lead you to complete a Section for an account type you already have, write your current account number in the ﬁeld provided within the Section.

•฀ Bidding for State Government Contract (State Vendor or Afﬁliates)—Any vendor who contracts to sell, install, or provide services to the Commonwealth of Kentucky or one of its agencies, or any afﬁliate of a company who contracts to sell, install, or provide services to the Commonwealth, is required to register for Kentucky sales and use tax per KRS 45A, and collect and remit the sales and use tax imposed by KRS Chapter 139. Complete Sections A, B, and C to determine the accounts for which you are required to apply.

•฀ Purchased an Existing Business—(This will include a business previously owned by a family member)

	If the business you purchased was a...		Then...

	n Sole Proprietorship
	n Joint Venture
	n General Partnership
	n Series of a Statutory Trust		You will need to apply for new accounts. List the previous owner’s
	n Limited Partnership (LP or PLP)		accounts in Section A, question 2, and complete Sections B, and C to
	n Limited Liability Partnership (LLP or PLLP)		determine the account for which you are required to re-apply.
	n Limited Liability Limited Partnership (LLLP or PLLLP)
	n Series of a Partnership
	n Series of a Limited Liability Company (LLC or PLLC)
	n Protected Cell Company (PCC)

			If:
			–you are converting the purchased business to a new ownership/entity
			type, or
			–the Federal Identiﬁcation Number (FEIN) has changed, or
	n Non-Proﬁt		–the Secretary of State Organization Number has changed.
	n Non-Proﬁt
	n Professional Service Corporation		Then you will need to apply for new accounts. List the previous owner’s
	n Corporation
	n Corporation		accounts in Section A, question 2, and complete Sections B, and C to
	n Association
	n Association		determine the account for which you are required to re-apply.
	n Cooperative
	n Cooperative
	n Limited Cooperative Association
	n Statutory Trust
	n Statutory Trust
	n Trust (non-statutory)		If the business’ ownership/entity type, Federal Identiﬁcation Number (FEIN)
	n Limited Liability Company (LLC or PLLC)
			and Secretary of State Organization Number will all stay the same, DO
			NOT use the Kentucky Tax Registration Application. You must use Form
			10A104, Update or Cancellation of Kentucky Tax Account(s), to provide
			the updated business and responsible party information.

Note to persons buying a business: Any person buying a business may incur a sales tax liability on the purchase of the business assets or become personally liable for the prior sales tax liability of the seller. It may be necessary for the purchaser to withhold a part of the sales price until veriﬁcation has been furnished by the seller that tax liabilities have been paid or do not exist. Therefore, it is important that anyone purchasing a business obtain a copy of Kentucky Revised Statutes 139.670 and 139.680 to determine the tax consequences and potential liability in such transactions. Copies are available at www.revenue.ky.gov, by writing the Ofﬁce of Sales and Excise Taxes, Department of Revenue, P. O. Box 1274, Frankfort, Kentucky 40602-1274, by calling (502) 564-5170, or by contacting any Kentucky Taxpayer Service Center listed on page 1 of these instructions.

•฀ Ownership/Entity Type Change or Conversion, Change in Federal Identiﬁcation Number (FEIN) or Kentucky Secretary of State Organization Number—The only ownership/entity type changes that do not require a business to apply for new accounts are those related to mere taxing election changes with the Internal Revenue Service (IRS).

If a Corporation elects or rescinds S-Corporation status or a Limited Liability Company (LLC) changes its taxing election, provided the Federal Identiﬁcation Number (FEIN) and Kentucky Secretary of State Organization Number stay the same, you must use Form 10A104, Update or Cancellation of Kentucky Tax Account(s), to provide the updated business and responsible party information.

For all other ownership/entity type changes or conversions, for receiving a new Federal Identiﬁcation Number (FEIN), or for receiving a new Kentucky Secretary of State Organization Number, you must apply for new Kentucky tax account numbers. List your old account numbers in Section A, question 2, and complete Sections B, and C to determine the accounts for which you are required to re-apply.

Examples of conversions requiring a business apply for new accounts are:

nA Sole Proprietorship converting to a General Partnership and vice versa,

nA Limited Liability Company (LLC or PLLC) converting to a Statutory Trust and vice versa, or

nAny ownership type converting to a Limited Liability Company (LLC or PLLC) and vice versa.

2.Previous Kentucky Account Numbers—If you have purchased an existing business, list the previous owner’s accounts, if available. If your current business has changed ownership/entity types, received a new Federal Identiﬁcation Number (FEIN) or a new Kentucky Secretary of State Organization Number and your company must apply for new accounts or you have resumed an old business, list your old accounts. A request in writing from the previous owner is required to cancel previous accounts.

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SECTION B—BUSINESS / RESPONSIBLE PARTY / CONTACT INFORMATION

3.Legal Business Name—Enter the complete legal business name for your business or organization.

4.Doing Business As (DBA)—If your business or organization has a “doing business as” name, enter the name.

5.Federal Employer Identiﬁcation Number (FEIN)—Enter the FEIN assigned to your business or organization by the Internal Revenue Service. Apply for an FEIN online at www.irs.gov or contact the IRS at (800) 829-4933. Sole Proprietorships and Disregarded Entities that do not have employees or ﬁle certain federal excise tax returns may not be required to hold an FEIN for Federal purposes. However, all businesses applying for Kentucky tax accounts are encouraged to obtain an FEIN. An FEIN helps distinguish a business from others with similar names and for certain documents may be an alternative to using a personal Social Security Number.

6.Secretary of State Information—(Sole Proprietorships, Estates, Governments, Unincorporated Non-Proﬁts, and Non-statutory Trusts are not required to register with the Kentucky Secretary of State. General Partnerships or Joint Ventures who do not operate using a DBA or Assumed Name are not required to register with the Kentucky Secretary of State.)

For all remaining entities, enter the Organization Number assigned to your entity by the Kentucky Secretary of State’s Ofﬁce. Enter your date of incorporation/ organization and list the State in which you incorporated/organized. If an out-of-state entity, list the date you qualiﬁed with the Kentucky Secretary of State’s Ofﬁce to do business in Kentucky.

7.Business Location—List the street address, city, state and ZIP Code for the location for which you are requesting registration. Do not list a P.O. Box for a business location address. For out-of-state businesses that do not have a Kentucky location, use the principal location address in your home state. If your location is in Kentucky, enter county name. If out-of-state, leave county blank. Enter the telephone number for the listed location; include the area code. If you have multiple Kentucky locations, attach a separate sheet which includes the information found in questions 3, 4, 7, and 15 for each location.

8.Location of Business Records—Give the address where business records for your taxes are located using the same entry criteria listed in question 7.

9.Accounting Period—Check the box that corresponds to when your business or organization’s accounting period ends. If you choose the ﬁscal year ﬁling box, enter the month and day when your year ends. If you choose the 52/53 week calendar year box, enter the day of the week your year ends in December. If you choose the 52/53 week ﬁscal year box, enter the month and day of the week your year ends.

Note: Most businesses operate under a calendar year basis (year end December 31).

10.Ownership Type—Check the box for the organizational structure type you have selected for your business. If “Other” selected, enter the structure type on the blank provided.

Ownership Type	Basic Deﬁnition

Sole Proprietorship	One single person owning and/or operating a business, solely responsible for all debts and liabilities
	incurred by the business.

General Partnership	Two or more individuals owning and/or operating a business. All partners jointly share proﬁts and losses
	and are individually responsible for debts incurred.

Joint Venture	A business entity that is short lived, generally common to construction related activities, where two
	or more individuals or businesses come together temporarily to participate in a proﬁt making activity.
	Usually, each venturer specializes in a speciﬁc ﬁeld of expertise or has resources not available to the
	other venturer(s).

Estate	The total property, real and personal, that was owned by an individual, now deceased, before distribution
	through a trust or will.

Government	City, county, state and federal agencies.

Unincorporated Non-Proﬁt	An unincorporated informal group of individuals who come together to perform some social good not
	conducted for pecuniary proﬁt. These can include unincorporated religious, educational, or charitable
	organizations.

Corporation	An organization chartered by law and recognized as having a legal existence as an entity separate from
	its owners. It operates under the direction of duly elected ofﬁcers.
Professional Service Corporation (PSC)	A PSC is a special type of corporation formed to engage in speciﬁc types of licensed professional services
	such as law, medicine, architecture, accounting, engineering, etc.

Association	An unincorporated group joined together for a common purpose. However, associations are treated as
	corporations for Department of Revenue purposes.

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Ownership Type	Basic Deﬁnition

Cooperative	A group of individuals known as patrons who have supplied their own capital at their own risk, who
	democratically direct and manage the enterprise, and who themselves receive the fruits of their cooperative
Limited Cooperative Association	endeavors, through the allocation of the excess among themselves. In general, Cooperatives are treated
	as corporations for Kentucky tax purposes.
	Limited Cooperative Associations must register as such with the Kentucky Secretary of State’s Ofﬁce.
	This ownership type allows for investor members in addition to patron members. For Kentucky purposes,
	Limited Cooperative Associations are also subject to the Limited Liability Entity Tax.

Trust (Non-statutory)	A legal entity that acts as ﬁduciary, agent or trustee on behalf of a person or business entity for the purpose
	of administration, management and the eventual transfer of assets to a beneﬁcial party.
Statutory Trust
	A Statutory Trust must register as such with the Kentucky Secretary of State’s Ofﬁce.
Series of a Statutory Trust
	A Series of a Statutory Trust is a Series that has been created underneath a Statutory Trust. Each
	Statutory Trust should register each of its separate Series with the Kentucky Secretary of State’s Ofﬁce
	as an assumed name.
	For Kentucky purposes, Statutory Trusts and Series of Statutory Trusts are subject to the Limited Liability
	Entity Tax.
	For Kentucky Department of Revenue purposes, each Series within a Statutory Trust must register for its
	own separate Limited Liability Entity Tax account, unless it has chosen a disregarded status.

Limited Partnership (LP and PLP)	A partnership formed by two or more persons having one or more general partners and one or more limited
	partners. The limited partner(s) have restricted liability for the business debts, while the general partner(s)
Limited Liability Partnership (LLP	are fully liable. Those with limited liability must form through the Secretary of State’s ofﬁce and not merely
or PLLP)	by a partnership agreement.
Limited Liability Limited Partnership	Some state’s Secretary of State’s Ofﬁces allow for the formation of Series underneath the main or master
(LLLP or PLLP)	Partnership.
Series of a Partnership	Each Partnership which has a Series should register each of its separate Series which do business in
	Kentucky with the Kentucky Secretary of State’s Ofﬁce as an assumed name.
	For Kentucky Department of Revenue purposes, each Series within a Partnership must register for its own
	separate Limited Liability Entity Tax account, unless it has chosen a disregarded status.

Limited Liability Company (LLC or	An organization of individuals chartered by law and operating under the direction of members or managers.
PLLC)	For US federal taxation purposes an LLC can be taxed as a single member disregarded entity, partnership,
	non-proﬁt, corporation or an S-corporation.
Series of a Limited Liability Company
	Some state’s Secretary of State’s Ofﬁces allow for the formation of Series underneath a main or master
	LLC.
	Each LLC which has a Series should register each of its separate Series which do business in Kentucky
	with the Kentucky Secretary of State’s Ofﬁce as an assumed name.
	For Kentucky Department of Revenue purposes, each Series within an LLC must register for its own
	separate Corporation Income Tax and/or Limited Liability Entity Tax account, unless it has chosen a
	disregarded status.

Protected Cell Company (PCC)	Also called a Segregated Cell Company, Segregated Account Company, or a Segregated Portfolio
	Company. Some state’s Secretary of State Ofﬁces allow the formation of a type of company which separates
Cell of a Protected Cell Company	its business into protected cells in which assets and liabilities of different classes are separated from the
	main company.
	For Kentucky Department of Revenue purposes, each Cell within a Protected Cell Company, must register
	for its own separate Corporation Income Tax and/or Limited Liability Entity Tax account, unless it has
	chosen a disregarded status.

Other	Any ownership not elsewhere classiﬁed.

11.How Will You be Taxed for Federal Purposes? Indicate how this business will be treated for Federal purposes. If “Single Member Disregarded Entity, Other” is selected, list what type of entity the single member is and how it is taxed.

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12-13. Ownership Disclosure—Responsible Parties— Enter the full legal name, Social Security Number, Kentucky Driver’s License Number, residence address, city, state, ZIP Code, telephone number, county (if in Kentucky), business title and the date for when the title became effective for the information that corresponds to your business ownership type. Note: Social Security Numbers for responsible parties are required (KRS 131.180(4)).

	If your Ownership Type is...	Then the required Ownership/Responsible Party disclosure is...

	n Sole Proprietorship	Enter owner’s individual information, including Social Security Number, in
	n Limited Liability Company (LLC or PLLC) for Federal Purposes Taxed	question 12.
	as an Individual Sole Proprietorship
		Note: For Kentucky purposes, a husband and wife who jointly own a business
		must register as a General Partnership and not a Sole Proprietorship.

	n Limited Liability Company (LLC or PLLC) for Federal Purposes Taxed	Enter the single member’s company information, including FEIN, in question
	as a Single Member Disregarded Entity	12.
		If the LLC has managers, their full individual information can be entered in
		question 13. Attach a separate sheet for more LLC managers.

	n Joint Venture	Enter the partners’/members’ information in questions 12 and 13. If partners/
	n General Partnership	members are individuals, provide their Social Security Numbers. If partners/
	n Limited Partnership (LP or PLP)	members are other businesses, provide their FEINs.
	n Limited Liability Partnership (LLP or PLLP)
	n Limited Liability Limited Partnership (LLLP or PLLLP)	If more than two partners/members; attach a separate sheet.
	n Limited Liability Company (LLC or PLLC) for Federal Purposes Taxed
	as Other Than Disregarded	Note: For any entity taxed as a partnership at least two partners/members
		must be listed.

	n Series of a Partnership	Enter the information for the master Partnership or master Limited Liability
	n Series of a Limited Liability Company	Company, including FEIN, in question 12.
		If the Series of the LLC has managers, their full individual information can
		be entered in question 13. Attach a separate sheet for more LLC managers
		of the Series.

	n Estate	Enter the information for the estate administrator, including Social Security
		Number, in question 12.

	n Professional Service Corporation (PSC)	Enter the ofﬁcers’ information, including Social Security Numbers in
	n Corporation	questions 12 and 13. If more than two ofﬁcers; attach a separate sheet.
	n Association
	n Cooperative	Note: Information for the President is required. The information for a
	n Limited Cooperative Association	President must be for an individual and not another business.
	n Non-proﬁt
	n Government

	n Statutory Trust	Enter the trustee information. If trustees are individuals, provide their Social
	n Series of a Statutory Trust	Security Numbers. If trustees are other businesses, provide their FEINs. If
	n Trust (non-statutory)	more than two trustees; attach a separate sheet.
		For a Series of a Statutory Trust, if it will be treated as a disregarded entity,
		also provide the information for the master Statutory Trust under which it
		was formed, including the FEIN for the master Statutory Trust.

	n Protected Cell Company	Enter the ofﬁcers’ information, including Social Security Numbers in
	n Cell of a Protected Cell Company	questions 12 and 13. If more than two ofﬁcers; attach a separate sheet.
		Note: Information for the President is required. The information for a
		President must be for an individual and not another business.
		For a Cell of a Protected Cell Company, if it will be treated as a disregarded
		entity, also provide the information for the Protected Cell Company under
		which the cell was formed, including the FEIN for the Protected Cell
		Company.

14.Person to contact about this application— Enter the name, title, daytime telephone number, extension, fax number and e-mail address for the person to contact with questions about this application.

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SECTION C—TELL US ABOUT YOUR BUSINESS OR ORGANIZATION—Answer questions 15 through 42 to determine accounts for which your business or organization is required to apply.

15.Business Activity Description—

A.Kentucky Activity—Give a description of the nature of your Kentucky business activity including a description of any services provided.

B.List Products Sold—If you make sales, list the type(s) of products that you sell in Kentucky.

C.Primary Activity Outside Kentucky—Give a description of the nature of your primary business activity outside the state of Kentucky, including a description of any services provided.

16.An employee is anyone to whom you pay wages, including part-time help and family members (See 103 KAR 18:010 and 103 KAR 18:070).

17.Kentucky withholding is not required from wages of Kentucky residents that work entirely outside the state or payments of pensions/retirements, but your business may choose to voluntarily register to withhold.

18.Kentucky ofﬁcers who receive compensation, other than dividends, are legally considered employees for withholding purposes.

19.All businesses or organizations making regular and continuous sales of Tangible Personal Property or Digital Property within Kentucky, including those via internet and at ﬂea markets or antique malls, are required to register for a Sales and Use Tax Account.

Tangible Personal Property (KRS 139.010(33)) “means personal property which may be seen, weighed, measured, felt or touched, or which is in any way or manner perceptible to the senses, regardless of the method of delivery, and includes natural, artiﬁcial, and mixed gas, electricity, water, steam, and prewritten computer software.” Digital Property (KRS 139.010(9)) “means any of the following which is transferred electronically: digital audio work, digital books, ﬁnished artwork, digital photographs, periodicals, newspapers, magazines, video greeting cards, audio greeting cards, video games, electronic games, or any digital code related to this property. Digital Property does not include audio-visual works or satellite radio programming.

20.A repairer or reconditioner of tangible personal property is a retailer of parts and materials furnished in connection with repair work and as such must collect sales and use tax (see 103 KAR 27:130 and 103 KAR 27:150). Charges, including labor charges, for producing, fabricating, processing, printing, or imprinting tangible personal property are subject to sales and use tax (see 103 KAR 28:030).

21.Rental of tangible personal property is a taxable activity. Additionally, if you have formed a separate business to hold title to equipment, machinery, or other tangible personal property for lease back to another business you own, you will be required to charge sales tax on those transactions (see 103 KAR 28:051).

22.In general, spectator admissions (for example: theaters, concerts, amusement parks, fairgrounds, baseball parks) are subject to sales tax. Non-spectator

admissions (for example: swimming pools, skating rinks, pay lakes) are not subject to sales tax (see 103 KAR 28:010).

23.Temporary rental of rooms, lodgings or accommodations by any hotel, motel, inn or tourist camp are subject to sales tax.

24.You as the agent are required to hold a Kentucky Sales and Use Tax Permit, if the manufacturer for whom you sell does not hold a valid Kentucky Sales and Use Tax Permit.

25.All receipts collected from the sales and use tax on the fees paid for breeding a stallion to a mare will be deposited into a fund, which will be administered by the Kentucky Horse Racing Authority to enhance the breeding industry in the state. Taxpayers who report sales tax on breeding fees are required to complete the Sales and Use Tax Equine Breeders Supplementary Schedule (Form 51A132) with their sales and use tax returns per 103 KAR 27:240.

Note: Copies of this supplemental schedule are available at www.revenue.ky.gov or for more information contact the Division of Sales and Use Tax, Department of Revenue, P.O. Box 181, Station 53, Frankfort, Kentucky 40602, or call (502) 564-5170.

26.Kentucky motor vehicle dealers who make sales of vehicles to residents of Arizona, California, Florida, Indiana, Massachusetts, Michigan, South Carolina or Washington must collect Kentucky sales tax on the selling price of the vehicle, less the trade-in allowance for like-kind exchanges. These receipts are to be reported and paid with the ﬁling of the dealer’s regular sales and use tax return. Taxpayers who report such sales are required to complete and ﬁle a Kentucky Sales Tax Motor Vehicle Sales Supplementary Schedule (Form 51A135) which provides a breakdown for the portion of total sales that relates speciﬁcally to sales of motor vehicles to those nonresident customers. The supplementary schedule is due on the same date as the sales and use tax return and may be ﬁled online at www.revenue.ky.gov .

Note: For more information contact the Division of Sales and Use Tax, Department of Revenue, P.O. Box 181, Station 53, Frankfort, Kentucky 40602, or call (502) 564-5170.

27.All receipts collected from the sales and use tax for aviation/jet fuel will be deposited into the Kentucky Aviation Economic Development Fund which is administered by the Kentucky Transportation Cabinet to enhance the aviation industry in the state. Taxpayers who report sales tax on aviation/jet fuel sales are required to complete the Sales and Use Tax Monthly Aviation Fuel Dealer Supplementary Schedule (Form 51A131) with their sales and use tax returns.

Note: Copies of this supplemental schedule are available at www.revenue.ky.gov or for more information, contact the Division of Sales and Use Tax, Department of Revenue, P.O. Box 181, Station 53, Frankfort, Kentucky 40602, or call (502) 564-5170.

28.A contract miner or a fee processor is an independent party to whom a manufacturer/industrial processor pays a fee to perform a step or series of steps in the manufacturing or mining process. Contract miners and fee processors may issue resale certiﬁcates for materials, supplies, and industrial tools used directly in the manufacturing/mining process provided the tools have a useful life of less than one year. Resale certiﬁcates cannot be issued for repair, replacement or spare parts.

29.All businesses engaged in selling coal and natural resources are required to obtain a Sales and Use Tax account. Sales of water, gas, electricity or sewer services to nonresidential customers are subject to sales tax. Communication services are also subject to sales and use tax.

*While the sale of cable, satellite broadcast and internet protocol television services are not subject to sales tax, cable services, satellite broadcast services, internet protocol television services and communication services are subject to telecommunications tax. Also, cable services, satellite broadcast services, internet protocol television services, communication services and the other utility services listed above are subject to utility gross receipts license tax.

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Page 7

Note: For more information about telecommunications tax, contact the Division of Sales and Use Tax, Department of Revenue, P.O. Box 181, Station 53, Frankfort, Kentucky 40602, or call (502) 564-5170 (Option 2). For more information about utility gross receipts license tax, contact the Financial Tax Section, Department of Revenue, P. O. Box 181, Station 61, Frankfort, Kentucky 40602, or call (502) 564-4810 (see KRS 136.600-136.660 and KRS 160.613).

30.These purchases are subject to Kentucky use tax. See Instruction 31 below.

31.Per KRS 139.330, a 6 percent use tax is due if you make out-of-state purchases of tangible personal property for storage, use, or other consumption in Kentucky and did not pay at least 6 percent state sales tax to the seller at the time of purchase. For example, if you order from catalogs, make purchases through the Internet, or shop outside Kentucky for items such as construction supplies, construction equipment, ofﬁce furniture, computer equipment, medical equipment, software, ofﬁce supplies, books, or subscribe to magazines or professional journals, you will owe use tax to Kentucky. This list is not all inclusive. It is important to remember that use tax applies only to items purchased outside Kentucky, including another country, which would have been taxed if purchased in Kentucky.

All professional service providers must apply for a Consumer’s Use Tax account.

32.- 33B. Every person engaged in severing and/or processing coal, including refuse coal, must ﬁle an application to obtain a Certiﬁcate of Registration and Coal Seller/Purchaser Certiﬁcate ID Number with the Kentucky Department of Revenue before severing and/or processing coal in Kentucky.

Processing includes cleaning, breaking, sizing, dust allaying, treating to prevent freezing, or loading or unloading for any purpose. This is limited to persons who own or have an economic interest in the coal and does not include a contract miner. Persons who only receive an arm’s length royalty are not considered as having an economic interest and are not required to register.

Note: Persons required to obtain a Certiﬁcate of Registration for coal severance and processing tax must also apply for a sales and use tax permit in Section E of this application.

33C. Coal Brokers, while not subject to coal tax, will be issued a Coal Seller/Purchaser Certiﬁcate ID Number that must be used in all sales and purchases of coal on Form 55A004.

34.These entities must register for a Kentucky Corporation Income Tax and/or a Limited Liability Entity Tax Account (see KRS 141.040 and KRS 141.0401).

35.For assistance, contact the Kentucky Secretary of State’s Ofﬁce at (502) 564-3490 or visit them online at http://sos.ky.gov .

36.A Commercial Domicile is the principal place from which the trade or business of the corporation is managed.

37.See deﬁnition in Instruction 19.

38.Corporations and Limited Liability Entities with individuals performing services in Kentucky are subject to Kentucky corporation income tax and/or limited liability entity tax. Services do not include the mere solicitation of the sale of tangible personal property.

39.A Pass-Through Entity is any partnership, joint venture, S corporation, limited cooperative association, statutory trust, series of a statutory trust, limited partnership (LP or PLP), limited liability partnership (LLP or PLLP), limited liability limited partnership (LLP or PLLP), series of a partnership, limited liability company (LLC or PLLC), series of a limited liability company, or similar entity recognized by the laws of this state that is not taxed for federal purposes at the entity level, but instead passes to each partner, member, shareholder, or owner their proportionate share of income, deductions, gains, losses, credits, and any other similar attributes. You are required to register for a Kentucky Corporation Income Tax Account and/or a Limited Liability Entity Tax Account to report the income generated from a pass-through entity.

40.You are required to register for a Kentucky Corporation Income Tax and/or a Limited Liability Entity Tax Account to report the income derived from or attributable to sources in Kentucky.

41.Directing activities at Kentucky customers for the purpose of selling goods or services is taxable in Kentucky.

42.Intangible property is subject to Kentucky corporate income tax and/or limited liability entity tax.

For Corporation Income Tax, nothing in questions 35 through 42 shall be interpreted in a manner that goes beyond the limitations imposed and protections provided by the United States Constitution or Public Law No. 86-272. Public Law No. 86-272 does not apply to the Limited Liability Entity Tax.

SECTION D—EMPLOYER’S WITHHOLDING TAX ACCOUNT

43.Existing Tax Account—If an Employer’s Withholding Tax account number has already been assigned to this business, check “Yes” and list the account number in B

If per Section A of the application your business was required to re-register for new accounts, or an Employer’s Withholding Tax Account was never assigned to your business, check “No” and leave B blank.

44.Number of Kentucky Employees—Enter the total number of full-time and part-time persons expected to be employed yearly in Kentucky; including Kentucky residents that perform work outside the state of Kentucky. For Kentucky businesses, who are for federal purposes electing taxation as corporations, include ofﬁcers who will be receiving compensation.

45.Date Wages or Pensions First Paid—Enter the date wages or pensions were or will be paid to employees.

46.Estimated Total Annual Tax Withheld—Check the estimated dollar amount of withholding you will be remitting to the Department of Revenue on an annual basis.

47.Send Mail Related to This Account to—If your mailing address is the same as the Business Location Address listed on Page 1, Section B, Question 7, then check the appropriate box.

If you want tax returns and correspondence to be sent somewhere other than the location address listed on Page 1, Section B, Question 7, complete the mailing address, city, state, ZIP Code, county (if in Kentucky), and the telephone number for this address in this section. You may include a P. O. Box here.

10A100-I (8-12)

Page 8

SECTION E—SALES AND USE TAX ACCOUNT (Including Transient Room Tax Account and Motor Vehicle Tire Fee Account)

48.Existing Tax Account—If a Sales and Use Tax account number has already been assigned to this business, check “Yes” and list the account number in B.

If per Section A of the application your business was required to re-register for new accounts, or a Sales and Use Tax Account was never assigned to your business, check “No” and leave B blank.

49.Date Sales Began or Will Begin—Give the date that sales, repairs, rentals, leases, lodgings, or admissions began or will begin in Kentucky.

50.Accounting Method—Check the box corresponding to the accounting method your company uses.

Cash Basis—The business elects to report receipts in the accounting period that payment is actually or constructively received from the customer, even though the customer may take possession of the product before actually paying for it.

Accrual Basis—The business elects to report receipts in the accounting period that the sale actually occurs, regardless of when the customer makes payment for such purchases.

51.Renting Temporary Lodging—Do you rent temporary lodging to others? Hotels, motels, inns, tourist camps or other businesses that rent temporary lodging or accommodations in Kentucky are subject to the transient room tax. If you are required to register for this tax, mark this question “Yes”. The transient room tax adds a 1 percent tax of the rent in addition to the current 6 percent sales tax (see KRS 142.400).

Note: For more information, contact the Excise Tax Section, Department of Revenue, P. O. Box 1303, Station 62, Frankfort, Kentucky 40602-1303, or call

(502)564-6823.

52.Sale of New Tires for Motor Vehicles—Do you make retail sales of new tires for motor vehicles within Kentucky? Retail businesses which sell new tires for motor vehicles are subject to the Motor Vehicle Tire Fee. If you are required to register for this fee, mark this question “Yes”.

Note: For more information, contact the Excise Tax Section, Department of Revenue, P. O. Box 1303, Station 62, Frankfort, Kentucky 40602-1303, or call

(502)564-6823.

53.Estimated Gross Monthly Sales Tax Collected—Check estimated amount of monthly sales tax collected in Kentucky.

54.Send Mail Related to This Account to—See Instruction 47 in Section D of these Instructions.

SECTION F—TELECOMMUNICATIONS TAX ACCOUNT AND/OR UTILITY GROSS RECEIPTS LICENSE TAX ACCOUNT

Note: Tax returns for Telecommunications Tax and Utility Gross Receipts License Tax are required to be ﬁled online. See the application for the website addresses to use to register for online ﬁling once your accounts have been assigned.

55.Existing Tax Account—If a Telecommunications Tax account number and/or a Utility Gross Receipts License Tax account has already been assigned to this business, check “Yes” and list the account number(s) in B.

If per Section A of the application your business was required to re-register for new accounts, or a Telecommunications Tax Account or a Utility Gross Receipts License Tax Account was never assigned to your business, check “No” and leave B blank.

56.Date Sales of Communications or Utilities Began or Will Begin—Give the date sales of communications and/or multichannel video programming services; water utilities; natural, artiﬁcial, or mixed gas; electricity; or sewer services began or will begin in Kentucky.

57.Telephone Number—List the telephone number for the business.

SECTION G—CONSUMER’S USE TAX ACCOUNT

58.Existing Tax Account—If a Consumer’s Use Tax account number has already been assigned to this business, check “Yes” and list the account number in B.

If per Section A of the application your business was required to re-register for new accounts, or a Consumer’s Use Tax Account was never assigned to your business, check “No” and leave B blank.

59.Date Purchases Began or Will Begin—Give the date that purchases of tangible personal property began or will begin.

Note: If your business did make or will make a one time only out-of-state purchase or will not regularly make these types of purchases, you will need to complete Form 51A113(O), Consumer’s Use Tax Return, to report and pay the applicable use tax. Do not complete this section to apply for a Consumer’s Use Tax Account. To obtain Form 51A113(O), call the Division of Sales and Use Tax at (502) 564-5170 or download the form from our Web site at www. revenue.ky.gov .

60.Send Mail Related to This Account to—See Instruction 47 in Section D of these Instructions.

SECTION H—COAL SEVERANCE/PROCESSING TAX AND/OR COAL SELLER/PURCHASER CERTIFICATE ID NUMBER

61.Existing Tax Account—If a Coal Severance/Processing Tax Account number and/or a Coal Seller/Purchaser Certiﬁcate ID number has already been assigned to this business, check “Yes” and list the account number in B.

If per Section A of the application your business was required to re-register for new accounts, or a Coal Severance/Processing Tax Account number or a Coal Seller/Purchaser Certiﬁcate ID number was never assigned to your business, check “No” and leave B blank.

62.Date Mining/Processing and/or Coal Brokering Began or Will Begin—Give the date mining/mining processing and/or coal brokering began or will begin in Kentucky.

63.Send Mail Related to This Account to—See Instruction 47 in Section D of these Instructions.

10A100-I (8-12)

Page 9

SECTION I—CORPORATION INCOME TAX ACCOUNT AND/OR LIMITED LIABILITY ENTITY TAX ACCOUNT

Note: All corporations and all limited liability entities should be registered with the Kentucky Secretary of State’s Ofﬁce. You may contact their ofﬁce at (502) 564- 3490, or visit their Web site at http://sos.ky.gov .

If your Company is a...	Then in general, the account type you qualify for is...

n Corporation	Both a Corporation Income Tax Account and a Limited Liability Entity Tax
n S Corporation	Account
n Association
n Limited Cooperative Association	(Unless otherwise exempt by statute)
n Protected Cell Company
n Any other entity that has elected to be taxed as a corporation or
S Corporation for federal income tax purposes

n Cooperative	A Corporation Income Tax Account
n Homeowner’s Association
n Professional Service Corporation (PSC)	(Unless otherwise exempt by statute)
n Real Estate Investment Trust (REIT)
n Regulated Investment Company (RIC)
n Real Estate Mortgage Investment Conduit (REMIC)
n Public Service Corporation
n Professional Limited Liability Company (PLLC) federally taxed as a
Corporation or S Corporation
n Other entity treated as a Corporation or S Corporation that is not subject
to the Limited Liability Entity tax imposed by KRS 141.0401(6)

n Statutory Trust	A Limited Liability Entity Tax Account
n Series of a Statutory Trust where the Series has not elected to be
taxed as a Corporation or S Corporation and has not elected to be	(Unless otherwise exempt by statute)
disregarded
n Limited Partnership (LP or PLP)
n Limited Liability Partnership (LLP or PLLP)
n Limited Liability Limited Partnership (LLLP or PLLLP)
n Series of a Partnership where the Series has not elected to be taxed
as a Corporation or S Corporation and has not elected to be disre-
garded
n Limited Liability Company (LLC or PLLC) federally taxed as a
Partnership
n Limited Liability Company (LLC or PLLC) federally treated as a
disregarded entity whose single member is a(n)
-Individual Sole Proprietor
-General Partnership
-Joint Venture
-Estate
-Trust (non-statutory)
n Series of a Limited Liability Company where the Series has not elected
to be taxed as a Corporation or S Corporation and has not elected to
be disregarded
n Cell of a Protected Cell Company where the Cell has not elected to
be taxed as a Corporation or S Corporation and has not elected to be
disregarded
n Similar entity that affords any of its partners, members, shareholders, or
owners, through function of the laws of Kentucky or laws recognized by
Kentucky, protection from general liability for actions of the entity and
have not elected to be taxed as a corporation or S Corporation for federal
income tax purposes

64.Existing Tax Account—If a Corporation Income Tax and/or a Limited Liability Entity Tax account number has already been assigned to this business, check “Yes” and list the account number in B.

If per Section A of the application your business was required to re-register for new accounts, or a Corporation Income Tax or a Limited Liability Entity Tax Account was never assigned to your business, check “No” and leave B blank.

65.Exempt Organizations—Indicate whether your business or organization is exempt from Corporation Income Tax and/or Limited Liability Entity Tax by Kentucky Statute. If “Yes” selected, select the speciﬁc exemption type in item B.

If you select “Political Organization” in B, indicate in item C whether your entity is required to ﬁle Federal Form 1120-POL.

Note to corporations exempt from federal income taxation: Corporations which are exempt from federal income taxation under Section 501(c)(3) of the Internal Revenue Code, must attach a copy of the determination of exemption letter issued by the IRS.

66.Entity Treated as a Division—If your entity is not separately taxed and is instead federally treated as a division of a parent company, check “Yes” and select the Division Type in item B.

67.Mere Solicitation—If you are an out-of-state entity, check if your activity in Kentucky is mere solicitation of the sale of tangible personal property which is protected under Public Law 86-272. Public Law 86-272 does not apply to the Limited Liability Entity Tax.

68.Date Activity Began for Out-of-State Entities—Enter the date that your business or organization began business activities in Kentucky or began receiving pass-through income from Kentucky sources.

69.Send Mail Related to This Account to—See Instruction 47 in Section D of these Instructions.

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10a100 form conclusion process detailed (portion 1)

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Fiscal Year, City, and Telephone Number of 10a100 form

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Mailing Telephone Number

County (if in Kentucky)