PRIME CONTRACTOR (CONSTRUCTION MANAGER) RESPONSE
REGISTRATION AND TAX IDENTIFICATION FORM
OFFICIAL/LEGAL NAME OF COMPANY:
Minn. Stat § 181.723 as amended (Minn. Laws, chapter 295) requires Contractors and Subcontractors that provide commercial or residential building construction or improvement services in Minnesota to be registered with the Minnesota Department of Labor and Industry by September 15, 2012, unless they are already licensed, certified or registered by the Minnesota Department of Labor and Industry. Contractors are required to have a Building Construction Contractor Registration No. prior to receiving a Contract Award. For additional information and to register go to www.dli.mn.gov/register or contact DLI at 651.284.5074 or email: .
A. BUILDING CONSTRUCTION CONTRACTOR REGISTRATION NO.: ______
Or LICENSE NO.:______TYPE OF LICENSE:______
Contractors are required to have a Minnesota Vendor ID prior to receiving a Contract Award. For information on requesting or registering your Minnesota Vendor ID: http://mn.gov/mmb/accounting/swift/vendor-resources/ .
B. STATE OF MINNESOTA VENDOR ID#______
Pursuant to Minn. Stat. § 270C.66, Minnesota Contract Vendors are required to provide their Minnesota Tax Identification Number (or and Federal Employer Identification Number (or Social Security Number). Non-Minnesota Contract Vendors are required to provide their Federal Employer I.D. Number (or Social Security Number) only. This information may be used in the enforcement of Federal and State Tax Laws. Supplying these numbers could result in action to require a Contract Vendor to file tax returns and pay delinquent State Tax Liabilities. These numbers will be available to Federal and State Tax Authorities and State personnel involved in the Payment of State obligations.
A. If a Corporation, what is the state of Incorporation?
B. If a Partnership, state full names of Copartners:
C. If a Limited Liability Company, what is the state in which formed:
D. If a sole proprietorship, are you an independent contractor? ____ Yes ____ No
E. SOCIAL SECURITY OR FEDERAL TAX I.D. #
MINNESOTA STATE TAX I.D.#