MMT - BUSINESS & PROFESSIONAL QUESTIONNAIRE

Monclova - Toledo Joint Economic Development Zone
(MMT JEDZ)  - Division of Taxation
400 Conant Street
Maumee, OH 43537
Ph:  419-897-7120   .   Fax:  419-897-8924
E-Mail:  tax@maumee.org


For the purpose of our records, with regard to MMT JEDZ Income Tax (1-1/2% withholding tax on employee wages and net profits), please complete and return this form promptly. Thank you.

1. Trade Name: ______________________________ Phone No._______________

2. MMT JEDZ Address: __________________________ Do you own this property? _____ 

If renting, give name and address of owner: __________________________________________

3. Address where forms should be sent for withholding and net profits attributable to MMT JEDZ: ___________________________________________________________

4. Starting date of MMT JEDZ activities: ______________________________________

5. What is the location of your current activity? _______________________________

6. Type of organization: Individual Proprietor ____ Corporation___ Partnership___ LLC ___ 
Other (please explain)______________________________________________________

7. Accounting Period: Calendar Year _________ or Fiscal Year ending ____________

8. Are there now or will there be employees subject to MMT JEDZ Income Tax?  Yes/No Approximate number of employees ______. Does your withholding amount to $300.00 or more per month?  $1,000 or more per month?
Yes _____(Monthly withholding is mandatory) No _____(Quarterly is sufficient).  Yes _____ (Monthly withholding over $1,000 ACH transfer is required www.maumee.org/residential/achcredit.htm, optional to all other withholders).

9. Name of Officer (if corporation) _____________________ Fed ID#.____________

10. Name of Owner ________________________________ SS#. _______________

11. Nature of business: __________________________________________________

12. Is local address the home office or a branch? _______________________________

IF BUSINESS WAS OUTGROWTH OF ANOTHER, FILL IN THE FOLLOWING:

13. Name of former owner(s):_____________________________________________

14. Trade name:_______________________________________________________

Date: _________ Signature: __________________________   Title: _____________________