Form CSBS-4
Application
Center for Simulated Business Services
1. Name of applicant (Legal name)
for Employer Identification Number
Keep a copy for your records
2.
Trade name of business (if different from name on line 1)
3.
Mailing address (street address) (room, or suite no.)
4.
City, state, and ZIP code
5.
County and state where business is located
6.
Name of principal officer
7.
Type of entity (check only one box
Sole proprietor (SSN
)
Personal service corporation
Partnership
8.
Other corporation (specify)
Reason for applying (Check one box)
Started new business
Hired employees
Banking purpose
Purchased going business
9. Date business started or acquired (Mo., day, year)
11. First date wages were or will be paid
EIN_NUM03
10.
Closing month of accounting year
(Mo., day., year)
12. To whom are most of the products or services sold?
Public (retail)
Other (specify)
Signature (Type name and Title)
EIN
Business (wholesale)
Telephone number
Fax number