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Indiana Free Printable  for 2024 Indiana Business Tax Clearance Form

Form 53227 is obsolete, and is no longer supported by the Indiana Department of Revenue.

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Business Tax Clearance Form
Form 53227

Indiana Department of Revenue State Form 53227 (R5 / 2-19) Tax Clearance Form Permit Number Hearing Date Expiration Date 1. Tax Identification Numbers Federal ID Number (FID) State Tax ID Number (TID) 2. Corporate, Partnership, or Sole Proprietor Information Name Phone Number Mailing or Street Address City State ZIP Code County 3.Business Trade Name (DBA) Name Phone Number Location Address City State 4. Nonprofit Information Is this business registered as a nonprofit organization in Indiana? 5.Type of Ownership □ □ Sole Proprietorship Partnership □ □ ZIP Code □ Yes □ Corporation (For Profit) Government □ No County If yes, what is your number? _________________________ Other (Specify) ______________________________ 6. All corporations, please complete the following information. All others, go to line 7. State of Incorporation Date of Incorporation If not a corporation, enter date authorized to do business in Indiana. 7. Bankruptcy Information Has this business entity ever filed bankruptcy? □ Yes □ State of Corporate Domicile Accounting Period Year Ending Date (mm dd) If so, when? ____________________________ No I authorize the Department of Revenue to release the current tax information of the applicant named above to the Alcohol and Tobacco Commission for the purpose of issuing an ABC Permit. Authorized Signature:_________________________________ Title:_________________________ This clearance is valid for thirty days only. Date:________________ To: Liquor Permit Applicants From: Indiana Department Of Revenue Subject:Tax Clearance Form IC 7.1-3-21-15 (a) (3) the commission shall not issue, renew, or transfer a wholesaler, retailer, dealer, or other permit of any type if the applicant is on the most recent tax warrant list supplied to the commission by the Department of State Revenue. To obtain such verification, applicants must file a completed Tax Clearance Form with the Department. Applicants must provide all requested information. Failure to timely file a Tax Clearance form or provide all requested information may result in delay or denial of your application. Applicants may mail the completed Tax Clearance Form to Titles & Clearances Division 100 N. Senate Ave, Indianapolis, IN 46204. Applicants may file the Tax Clearance Form in person at Room N-105, Indiana Government Center North. The Department of Revenue will provide information concerning tax liabilities of applicants to the Alcohol and Tobacco Commission (ATC). ATC will provide verification of the applicant’s tax status to the local alcoholic beverage board. For further information, call (317) 232-5977. The original blue form must be completed, signed and returned for approval. This clearance is valid for thirty days only. Department Use Only A/R __________________________________________ RST ____________________________________________ WTH _________________________________________ FAB _____________________________________________ CIT ___________________________________________ IND _____________________________________________ COR__________________________________________ NFP ____________________________________________ Employee______________________________________ Date ____________________________________________ Supervisor _______________________________________
Extracted from PDF file 2019-indiana-form-53227.pdf, last modified February 2019

More about the Indiana Form 53227 Other

We last updated the Business Tax Clearance Form in May 2021, and the latest form we have available is for tax year 2019. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Indiana Department of Revenue. You can print other Indiana tax forms here.

Other Indiana Other Forms:

TaxFormFinder has an additional 69 Indiana income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 130 Taxpayer's Notice to Initiate a Property Tax Appeal
Form 104 Business Tangible Personal Property Return
Form 43708 Application for Senior Citizen Property Tax Benefits
Form 102 Farmer's Tangible Personal Property Assessment Return
Form 103-Short Business Tangible Personal Property Return

Download all IN tax forms View all 70 Indiana Income Tax Forms


Form Sources:

Indiana usually releases forms for the current tax year between January and April. We last updated Indiana Form 53227 from the Department of Revenue in May 2021.

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Historical Past-Year Versions of Indiana Form 53227

We have a total of two past-year versions of Form 53227 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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