Form REG-1 "Illinois Business Registration Application" - Illinois

Form REG-1 is a Illinois Department of Revenue form also known as the "Illinois Business Registration Application". The latest edition of the form was released in September 1, 2018 and is available for digital filing.

Download a PDF version of the Form REG-1 down below or find it on Illinois Department of Revenue Forms website.

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Download Form REG-1 "Illinois Business Registration Application" - Illinois

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Use your 'Mouse' or the 'Tab key' to move through the fields and 'Mouse' or 'Space bar' to enable the checkboxes.
Illinois Department of Revenue
REG-1
Illinois Business Registration Application
Register faster using MyTax Illinois, our online account management program, available at mytax.illinois.gov. If you have questions, visit our
website at tax.illinois.gov or call us weekdays between 8:00 a.m. and 4:30 p.m. at 217 785-3707.
Step 1: Identify your business or organization
6
Check the organization type that applies to you:
q
Proprietorship
1
Federal employer identification number (FEIN)
____ Check if owned by a married couple or civil union
FEIN: ______ - __________________
q
q
Partnership
Trust or estate
Proprietorships must provide the Social Security number (SSN)
*
*
q
q
under which taxes will be filed.
Corporation
S Corp (Subchapter S Corporation)
*
SSN: _________ - ______ - ____________
Is your corporation publicly traded? ___ Yes
___ No
If yes, provide the ticker symbol ____________
2
Legal business name:
q
q
Governmental unit
Not-for-profit organization
___________________________________________________
q
q
LLC - Corporation
LLC - Partnership
3
Doing-business-as (DBA), assumed, or trade name, if different
q
LLC - Single member ____ Check if disregarded
from Line 2:
If you are applying to be a Scholarship Granting Organization under the
___________________________________________________
Invest in Kids Act of 2017, you must apply online using MyTax Illinois,
available at mytax.illinois.gov.
4
Primary or legal business address:
7
Illinois Secretary of State identification number:
___________________________________________________
___ - ___ ___ ___ ___ - ___ ___ ___ - ___
Street address - No PO Box number
Apartment or suite number
8
Is your business part of a unitary group? ___ Yes
___ No
___________________________________________________
If “Yes”, provide the FEIN of your designated agent (the entity
City
State
ZIP
If you have other locations in Illinois from where you do
responsible for filing your Illinois income tax return):
business, complete and attach Schedule REG-1-L.
FEIN: ______ - __________________
5
Mailing address if different from the address above:
9
Identify a contact person regarding your business.
___________________________________________________
Name: __________________________ Title: _____________
In-care-of name
Phone: (______) ______ - ________ Ext.: __________
___________________________________________________
FAX:
(______) ______ - ________
Street address or PO Box number
Apartment or suite number
___________________________________________________
Email address: ______________________________________
City
State
ZIP
Step 2: Identify your owners and officers
- If you need to identify more, attach Schedule REG-1-O.
10
Identification depends on the organization type you selected in Step 1, Line 6 (proprietorship - owner(s); partnership - general partners; non-publicly traded
corporation - president, secretary, and treasurer; publicly traded corporation - chief operating officer and chief financial officer; trust or estate - trustee(s) or
executor(s); governmental unit - one contact person; not-for-profit organization - president, secretary, or treasurer; limited liability company - managers and
members). For each individual or business required, complete the following information.
Individuals:
(include Social Security number (SSN))
d
a
___________________________________ _________________
___________________________________ _________________
Name
Title
Name
Title
______________________________________________________
______________________________________________________
Home address - No PO Box number
City
State
ZIP
Home address - No PO Box number
City
State
ZIP
____ / ____ / ________
(______) ______ - ________
____ / ____ / ________
(______) ______ - ________
Date of birth
Phone
Date of birth
Phone
_______ - _____ - _________
______
Ownership percentage:
_______ - _____ - _________
______
Ownership percentage:
Social Security number
Social Security number
Businesses:
(include federal employer identification number (FEIN))
b
___________________________________ _________________
a
Name
Title
___________________________________ ____-_____________
Name
FEIN
______________________________________________________
Home address - No PO Box number
______________________________________________________
City
State
ZIP
Legal address
____ / ____ / ________
(______) ______ - ________
______________________________________________________
Date of birth
Phone
City
State
ZIP
_______ - _____ - _________
______
Ownership percentage:
(______) ______ - ________
______
Ownership percentage:
Social Security number
Phone
c
___________________________________ _________________
b
___________________________________ ____-_____________
Name
Title
Name
FEIN
______________________________________________________
______________________________________________________
Home address - No PO Box number
City
State
ZIP
Legal address
______________________________________________________
____ / ____ / ________
(______) ______ - ________
City
State
ZIP
Date of birth
Phone
(______) ______ - ________
______
_______ - _____ - _________
______
Ownership percentage:
Ownership percentage:
Phone
Social Security number
REG-1 (R-09/18)
*874501110*
Use your 'Mouse' or the 'Tab key' to move through the fields and 'Mouse' or 'Space bar' to enable the checkboxes.
Illinois Department of Revenue
REG-1
Illinois Business Registration Application
Register faster using MyTax Illinois, our online account management program, available at mytax.illinois.gov. If you have questions, visit our
website at tax.illinois.gov or call us weekdays between 8:00 a.m. and 4:30 p.m. at 217 785-3707.
Step 1: Identify your business or organization
6
Check the organization type that applies to you:
q
Proprietorship
1
Federal employer identification number (FEIN)
____ Check if owned by a married couple or civil union
FEIN: ______ - __________________
q
q
Partnership
Trust or estate
Proprietorships must provide the Social Security number (SSN)
*
*
q
q
under which taxes will be filed.
Corporation
S Corp (Subchapter S Corporation)
*
SSN: _________ - ______ - ____________
Is your corporation publicly traded? ___ Yes
___ No
If yes, provide the ticker symbol ____________
2
Legal business name:
q
q
Governmental unit
Not-for-profit organization
___________________________________________________
q
q
LLC - Corporation
LLC - Partnership
3
Doing-business-as (DBA), assumed, or trade name, if different
q
LLC - Single member ____ Check if disregarded
from Line 2:
If you are applying to be a Scholarship Granting Organization under the
___________________________________________________
Invest in Kids Act of 2017, you must apply online using MyTax Illinois,
available at mytax.illinois.gov.
4
Primary or legal business address:
7
Illinois Secretary of State identification number:
___________________________________________________
___ - ___ ___ ___ ___ - ___ ___ ___ - ___
Street address - No PO Box number
Apartment or suite number
8
Is your business part of a unitary group? ___ Yes
___ No
___________________________________________________
If “Yes”, provide the FEIN of your designated agent (the entity
City
State
ZIP
If you have other locations in Illinois from where you do
responsible for filing your Illinois income tax return):
business, complete and attach Schedule REG-1-L.
FEIN: ______ - __________________
5
Mailing address if different from the address above:
9
Identify a contact person regarding your business.
___________________________________________________
Name: __________________________ Title: _____________
In-care-of name
Phone: (______) ______ - ________ Ext.: __________
___________________________________________________
FAX:
(______) ______ - ________
Street address or PO Box number
Apartment or suite number
___________________________________________________
Email address: ______________________________________
City
State
ZIP
Step 2: Identify your owners and officers
- If you need to identify more, attach Schedule REG-1-O.
10
Identification depends on the organization type you selected in Step 1, Line 6 (proprietorship - owner(s); partnership - general partners; non-publicly traded
corporation - president, secretary, and treasurer; publicly traded corporation - chief operating officer and chief financial officer; trust or estate - trustee(s) or
executor(s); governmental unit - one contact person; not-for-profit organization - president, secretary, or treasurer; limited liability company - managers and
members). For each individual or business required, complete the following information.
Individuals:
(include Social Security number (SSN))
d
a
___________________________________ _________________
___________________________________ _________________
Name
Title
Name
Title
______________________________________________________
______________________________________________________
Home address - No PO Box number
City
State
ZIP
Home address - No PO Box number
City
State
ZIP
____ / ____ / ________
(______) ______ - ________
____ / ____ / ________
(______) ______ - ________
Date of birth
Phone
Date of birth
Phone
_______ - _____ - _________
______
Ownership percentage:
_______ - _____ - _________
______
Ownership percentage:
Social Security number
Social Security number
Businesses:
(include federal employer identification number (FEIN))
b
___________________________________ _________________
a
Name
Title
___________________________________ ____-_____________
Name
FEIN
______________________________________________________
Home address - No PO Box number
______________________________________________________
City
State
ZIP
Legal address
____ / ____ / ________
(______) ______ - ________
______________________________________________________
Date of birth
Phone
City
State
ZIP
_______ - _____ - _________
______
Ownership percentage:
(______) ______ - ________
______
Ownership percentage:
Social Security number
Phone
c
___________________________________ _________________
b
___________________________________ ____-_____________
Name
Title
Name
FEIN
______________________________________________________
______________________________________________________
Home address - No PO Box number
City
State
ZIP
Legal address
______________________________________________________
____ / ____ / ________
(______) ______ - ________
City
State
ZIP
Date of birth
Phone
(______) ______ - ________
______
_______ - _____ - _________
______
Ownership percentage:
Ownership percentage:
Phone
Social Security number
REG-1 (R-09/18)
*874501110*
Step 3: Tell us about your business activities
Services
Do you transfer items, on which tax must be collected, as part of
11
Describe your business activities: ______________________
____________________________________________
your service?
____ Yes
____ No
When will (did) this activity begin? ____/____/_____
Provide your North American Industry Classification System
Use
(NAICS) number: ___________________________________
Refer to the website www.naics.com
Does your supplier collect Illinois Sales Tax for merchandise your
12
Will you have Illinois employees?
____ Yes
____ No
business uses or consumes in Illinois?
If yes, complete and attach Schedule REG-UI-1.
____ Yes
____ No
When was (is) the date of your first payroll in Illinois?
Does your supplier collect Illinois Sales Tax on sales of aviation
____/____/_____
fuel your business uses or consumes in Illinois?
13
Check all that apply to your type of business.
____ Yes
____ No
When will (did) these activities begin? ____/____/_____
Sales
Cigarettes and other tobacco products
You must complete and attach Schedule REG-1-L to identify
q
all Illinois locations from which you make retail sales.
C
igarettes - See Schedule REG-1-C before you check here.
q
q
General merchandise: ____ Retail
____ Wholesale
Tobacco products - See Schedule REG-1-C before you check
Note: You must check “Retail” above if you make retail
here.
q
sales that are filled from inventory that is maintained in
Cigarette machine operator - See Schedule REG-1-C before
Illinois prior to its delivery to your Illinois purchaser.
you check here.
q
Sales to Illinois customers from out of state
When will (did) these activities begin? ____/____/_____
____ Check here if you have an Illinois presence,
Renting or leasing
including, but not limited to having an office or
q
Hotel rooms for less than 30 days - Attach Schedule REG-1-L.
other facility in Illinois or having employees or other
Do you charge for telecommunication services?
representatives operating in Illinois.
____ Yes
____ No
____ Check here if you make $100,000 or more in annual
q
Vehicles for one year or less - Attach Schedule REG-1-L.
sales to Illinois customers.
q
Vehicles for more than one year
____ Check here if you make 200 or more separate
When will (did) these activities begin? ____/____/_____
transactions annually to Illinois customers.
Utility providers
Do you estimate your monthly sales and use tax liability
q
Electricity: ____ Retail
____ Wholesale
____ Yes
____ No
will be over $200?
q
Natural gas: ____ Retail
____ Wholesale
q
Soft drinks (other than fountain soft drinks) in Chicago
q
Telecommunications - See Schedule REG-1-T.
q
Vehicle, watercraft, aircraft, or trailers
____ Retail
____ Wholesale
q
Sales or delivery of tires. Do you always pay the
q
Water or sewer services
Tire User Fee to your supplier?
____ Yes
____ No
Are you a utility cooperative?
____ Yes
____ No
q
Sales from vending machines. How many vending
Are you a municipality?
____ Yes
____ No
machines?
____
When will (did) these activities begin? ____/____/_____
q
Liquor at retail (bar, tavern, liquor store, etc.)
All other tax types
q
Motor fuel/fuel: ____ Retail
____ Wholesale
q
Liquor warehousing - Attach Schedule REG-1-A.
____ Check here if you are required to collect prepaid
q
Dry cleaning: ____ Facility
____ Solvent supplier
sales tax.
q
Own/operate coin-operated amusement devices
q
Medical cannabis - Attach Schedule REG-1-MC.
q
You wish to purchase electricity for non-residential use and pay
____ Cultivation Center
____ Dispensing Organization
the tax to IDOR - Attach Schedule REG-1-D.
q
Aviation fuel: ____ Retail
____ Wholesale
q
You wish to purchase natural gas from outside of
(if wholesale, attach Schedule REG-8-A)
Illinois for your own use and pay the tax to IDOR - Attach
When will (did) these activities begin? ____/____/_____
Schedule REG-1-G.
q
Not listed. Identify: ___________________________________
When will (did) these activities begin? ____/____/_____
Step 4: Sign below
Under penalties of perjury, I state that I have examined this information and, to the best of my knowledge, it is true, correct, and complete.
I further attest that I will be responsible for filing returns and paying all taxes due unless Schedule REG-1-R, Responsible Party Information, is
q
attached to this application or forwarded to the department. Check here if you are attaching or forwarding Schedule REG-1-R:
Signature:
_______________________________________
Title:
________________________
Date: ___/___/______
Printed name:
_______________________________________
SSN:
______ - _____ - _________
Address:
_______________________________________
Phone: (______) ______ - _________
Mail your completed form, with any required
CENTRAL REGISTRATION DIVISION
ILLINOIS DEPARTMENT OF REVENUE
attachments and payment to:
PO BOX 19030
SPRINGFIELD IL 62794-9030
This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this
information is required. Failure to provide information may result in this form not being processed and may result in a penalty.
*874512110*
REG-1 (R-09/18)
Printed by the authority of the State of Illinois - Web only - One copy
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