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Kentucky Free Printable  for 2024 Kentucky Update or Cancellation of Kentucky Tax Account(s)

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

10A104 (08-20) Commonwealth of Kentucky DEPARTMENT OF REVENUE UPDATE OR CANCELLATION OF KENTUCKY TAX ACCOUNT(S) FOR OFFICE USE ONLY CRIS Coded / Entered / Date Commonwealth Business Identifier (CBI) NAICS • Incomplete or illegible updates will delay processing and will be returned. • See instructions for questions regarding completion of this form. • Need Help?  Call (502) 564-2694 or visit www.revenue.ky.gov Federal Employer Identification Number (FEIN) SECTION A REASON FOR COMPLETING THIS UPDATE (Must Be Completed) This Form may only be used to update current account information. To apply for additional accounts or to reinstate previous account numbers, use Form 10A100, Kentucky Tax Registration Application. 1. Current Account Numbers Kentucky Employer’s Withholding Tax_____________________________ Kentucky Sales and Use Tax____________________________________ Kentucky Telecommunications Tax_______________________________ Kentucky Utility Gross Receipts License Tax________________________ Kentucky Consumer’s Use Tax__________________________________ Kentucky Corporation Income Tax and/or Kentucky Limited Liability Entity Tax____________________________ Kentucky Coal Severance and Processing Tax______________________ Kentucky Pass-Through Non-Resident WH_________________________ SECTION B New Name (if applicable) _________________________________________________________ _________________________________________________________________ _________________________________________________________ ___________________________________________________________ Doing Business As (DBA) Name Current DBA New DBA _________________________________________________________ 5.  / Check all that apply.  Update business name or DBA name  Update an existing location’s information for the Sales and Use Tax Account  Close a location of current business for the Sales and Use Tax Account  Open a new location of current business for the Sales and Use Tax Account  Add a mine location to an existing Coal Tax Account  Change accounting periods  Change taxing election  Update/provide new responsible party information  Update mailing address(es) / mailing address telephone number(s)  Request cancellation of an account  Closing business / Close all tax accounts BUSINESS AND CONTACT INFORMATION (Must Be Completed) 3. Legal Business Name Current Name 4.  /        2. Effective Date Federal Employer Identification Number (FEIN) (Required, complete prior to submitting) 7. Commonwealth Business Identifier (CBI) 8. Person to Contact Regarding this Update Form: Name (Last, First, Middle) _________________________________________________________________ 6. Kentucky Secretary of State Organization Number (If applicable) Title Daytime Telephone ( E-mail: (By supplying your e-mail address you grant the Department of Revenue permission to contact you via E-mail.) ) Extension –  10A104 (08-20) SECTION C Page 2 SALES AND USE TAX LOCATION INFORMATION 9. Update or Close an existing Business Location for your Sales and Use Tax Account. CURRENT LOCATION ADDRESS INFORMATION NEW LOCATION ADDRESS INFORMATION Business Location Name “Doing Business as” Name Business Location Name “Doing Business as” Name Street Address (DO NOT List a PO Box) Street Address (DO NOT List a PO Box)  Close Location     Update/Move Location City State Zip Code City State Zip Code County (if in Kentucky) Location Telephone Number ( ) County (if in Kentucky) Location Telephone Number –  ( ) –  Date Location Closed (mm/dd/yyyy) / / 10. - 11. Opened a new Location(s) of Current Business NEW LOCATION ADDRESS NEW LOCATION ADDRESS Business Location Name “Doing Business as” Name Business Location Name “Doing Business as” Name Street Address (DO NOT List a PO Box) Street Address (DO NOT List a PO Box) City State Zip Code State Zip Code County (if in Kentucky) Telephone Number ( ) County (if in Kentucky) Telephone Number –  Date Location Opened (mm/dd/yyyy) City ( / / –  / / Description of Business Activity Performed at Location Description of Business Activity Performed at Location SECTION D ) Date Location Opened (mm/dd/yyyy) UPDATE ACCOUNTING PERIOD, OWNERSHIP TYPE, AND/OR RESPONSIBLE PARTIES 12. Accounting Period change with the Internal Revenue Service (IRS) Accounting Period  Calendar Year (year ending December 31st)  Fiscal Year (year ending ___ ___/___ ___ (mm/dd))  52/53 Week Calendar Year:  52/53 Week Fiscal Year: December __________________________ __________________________________________ (Day of Week that year ends) (Month & Day of Week that year ends) 13. Taxing Election Change with the IRS (Note: If your Business Structure has changed, you are required to apply for new tax account numbers with the Department of Revenue. Please complete Form 10A100, Kentucky Tax Registration Application.) A. Current Business Structure ____________________________________________________________________ B. CURRENT TAXING ELECTION NEW TAXING ELECTION  Partnership  Corporation  S-Corporation  Cooperative  Trust  Partnership  Corporation  S-Corporation  Cooperative  Trust   Single Member Disregarded Entity (Member Federally Taxed as)   Individual Sole Proprietorship   General Partnership/Joint Venture  Estate   Trust (non-statutory)/Business Trust  Other_______________________________________   Single Member Disregarded Entity (Member Federally Taxed as)   Individual Sole Proprietorship   General Partnership/Joint Venture  Estate   Trust (non-statutory)/Business Trust  Other_______________________________________ 10A104 (08-20) Page 3 14.-15. OWNERSHIP DISCLOSURE—RESPONSIBLE PARTY UPDATE Provide updated information for existing responsible parties or add additional responsible parties.   New Responsible Party    Update Existing    End Date   New Responsible Party    Update Existing    End Date Full Legal Name (First, Middle, Last) Full Legal Name (First, Middle, Last) Social Security Number FEIN (If Responsible Party is another (REQUIRED) business) Social Security Number FEIN (If Responsible Party is another (REQUIRED) business) Driver’s License Number (if applicable) Driver’s License State of Issuance Driver’s License Number (if applicable) Driver’s License State of Issuance Business Title Effective Date of Title (mm/dd/yyyy) Business Title Effective Date of Title (mm/dd/yyyy) / / Residence Address / / Residence Address City State Zip Code City State Zip Code Telephone Number ( ) County (if in Kentucky) Telephone Number –   ( ) County (if in Kentucky) –   Does this Responsible Party replace an existing one? Does this Responsible Party replace an existing one? Yes    No   Yes    No   Existing Responsible Party’s Name End Date (mm/dd/yyyy) / / SECTION E 17. Tax Accounts for which the Address Change Applies (Check all that apply)   Employer’s Withholding Tax   Consumer’s Use Tax   Sales and Use Tax   Corporation Income Tax and/or Limited Liability Entity Tax   Transient Room Tax   Motor Vehicle Tire Fee   Commercial Mobile Radio Service (CMRS) Prepaid Service Charge Account c/o or Attn. Address City   Pass-Through Non Resident Withholding State Zip Code County (if in Kentucky)   Coal Severance and Processing Tax 19. Start Date for Address Change Mailing Telephone Number ( )  –  Note: To change the address or phone number for Telecommunications Tax or Utility Gross Receipts License Tax, you must use the online system. 21. List New Mailing Address  /         / 20. Tax Accounts for which the Address Change Applies (Check all that apply)   Employer’s Withholding Tax   Consumer’s Use Tax   Sales and Use Tax   Corporation Income Tax and/or Limited Liability Entity Tax   Commercial Mobile Radio Service (CMRS) Prepaid Service Charge Account / / 18. List New Mailing Address  /         /   Motor Vehicle Tire Fee End Date (mm/dd/yyyy) UPDATE MAILING ADDRESS AND PHONE NUMBERS FOR TAX ACCOUNTS 16. Start Date for Address Change   Transient Room Tax Existing Responsible Party’s Name   Coal Severance and Processing Tax   Pass-Through Non Resident Withholding c/o or Attn. Address City State Zip Code County (if in Kentucky) Mailing Telephone Number ( )  –  Note: To change the address or phone number for Telecommunications Tax or Utility Gross Receipts License Tax, you must use the online system. 10A104 (08-20) Page 4 SECTION F REQUEST CANCELLATION OF ACCOUNT(S) 22. TAX ACCOUNTS FOR WHICH CANCELLATION IS REQUESTED (Check all that Apply)   Employer’s Withholding Tax   Sales and Use Tax   Consumer’s Use Tax   Transient Room Tax   Motor Vehicle Tire Fee   Telecommunications Tax   Utility Gross Receipts License Tax   Corporation Income Tax and/or Limited Liability Entity Tax   Coal Severance and Processing Tax 23. REASON FOR CANCELLATION NOTE: A corporation’s or limited liability pass-through entity’s income tax/LLET account number is cancelled with the filing of the “final” return. A corporation or limited liability pass-through entity organized in Kentucky shall not file a final return before it is officially dissolved pursuant to the provisions of KRS Chapter 14A.  /         / 24. Effective Date to Cancel Account(s)   Business sold (See #25)   Ceased having employees   Ceased making retail and/or wholesale sales of tangible   Death of owner personal property or digital property   Converted to another ownership type and must   Merged out of existence reapply for new accounts (See #26)   No further Kentucky activity  Other (Specify): __________________________ __________________________   Pass-Through Non Resident Withholding   Commercial Mobile Radio Service (CMRS) Prepaid Service Charge Account   Business closed/No further Kentucky activity 25. If business sold, list the information for the new owner(s). Name Name Address Address City State Zip Code City State Zip Code Telephone Number ( ) Telephone Number –  ( ) –  26. If merged out of existence, list the information for the new business. Business Name Address FEIN Telephone Number ( ) City –  State Zip Code IMPORTANT: THIS UPDATE FORM MUST BE SIGNED BELOW: The statements contained in this Form 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 the Form. Printed Name:_______________________________________________________ Printed Name:_______________________________________________________ Signature:__________________________________________________________ Signature:__________________________________________________________ Title:_______________________________________ Date: ____/____/______ Title:_______________________________________ Date: ____/____/______ Telephone Number:___________________________________________________ Telephone Number:___________________________________________________ For assistance in completing the Update Form, please call the Data Integrity Section at (502) 564-2694, or you may use the Telecommunications Device for the Deaf. SEND completed form to: KENTUCKY DEPARTMENT OF REVENUE 501 HIGH STREET, STATION 20A FRANKFORT, KENTUCKY 40601 FAX to: 502-564-0796 EMAIL: [email protected] The Kentucky Department of Revenue does not discriminate on the basis of race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity, veteran status, genetic information or ancestry in employment or the provision of services.
Extracted from PDF file 2023-kentucky-form-10a104.pdf, last modified August 2020

More about the Kentucky Form 10A104 Other TY 2023

We last updated the Update or Cancellation of Kentucky Tax Account(s) in January 2024, so this is the latest version of Form 10A104, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form 10A104 directly from TaxFormFinder. You can print other Kentucky tax forms here.


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Other Kentucky Other Forms:

TaxFormFinder has an additional 129 Kentucky income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form K-4 Kentucky Withholding Certificate (K-4)
Form 10A100 Kentucky Tax Registration Application and Instructions
Form 10A104 Update or Cancellation of Kentucky Tax Account(s)
Form 62A350 Property Tax Application for Exemption Under the Homestead/Disability Amendment
Form 62F003 Instructions for Kentucky Property Tax Assessment Appeals

Download all KY tax forms View all 130 Kentucky Income Tax Forms


Form Sources:

Kentucky usually releases forms for the current tax year between January and April. We last updated Kentucky Form 10A104 from the Department of Revenue in January 2024.

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Historical Past-Year Versions of Kentucky Form 10A104

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