Form IBR-1 Idaho Business Registration Form - Idaho

Form IBR-1 or the "Idaho Business Registration Form" is a form issued by the Idaho State Tax Commission.

Download a PDF version of the Form IBR-1 down below or find it on the Idaho State Tax Commission Forms website.

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F
IBR-1
Idaho Business Registration Form
O
Revised
R
2014
EFO00147
Register online at: business.idaho.gov
M
07-01-14
Fax to: (208) 334-5364
IDAHO BUSINESS REGISTRATION
SHADED AREAS FOR STATE USE ONLY
Return to:
PO BOX 36
Account Number
Confirmation No.
BOISE, IDAHO 83722-0410
1a. If LLC, how have you chosen to be
___ Corporation
___ Partnership
___ S Corporation
___ Sole Proprietorship
1. Type of business
taxed for income tax purposes?
Single Member
Corporation
___ Nonprofit
___ Government
___ Fiduciary/Trust
___ Limited Liability Company
(see instructions)
Partnership
S Corporation
___ New applicant
___ Change legal name
___ Change assumed business name (DBA)
2. Purpose of registration
___ Add new account type ___ Add/change location
___ Change in partners, shareholders or managing members ____%
___ Boise Auditorium
___ E911 Prepaid Wireless Fee
___ Travel & Convention
___ Sales
___ Use
3. Apply for permits/accounts
___ Unemployment
___ Withholding
___ Withholding only, no employees working in Idaho
Request more information
___ Amusement Device
___ Beer/Wine
___ Cigarette/Tobacco
4. Federal Employer Identification Number (EIN)
5. Social Security number (SSN)
6. Legal business name (see instructions)
8. Date incorporated
9. State incorporated in
10. Month tax year ends
7. Assumed business name (DBA)
11. Date business began in Idaho
12. Date sales or use
13. Estimated monthly taxable sales
will begin in Idaho
month
year
14. Physical location of
Street address
City
State
Zip Code
business (no PO Box or
mail drop addresses)
15. Mailing address
Street address or PO Box
City
State
Zip Code
Street address or PO Box
City
State
Zip Code
16. Mailing address
for report forms
18. Authorized contact person (name and title) See instructions for definition.
17. Business telephone number
(
)
19. Telephone number & extension of contact person
20. Email address of contact person
21. Fax number of contact person
(
)
22. Primary nature of business: (Specify the product manufactured and/or sold or the type of service performed.)
23. Have you ever had a withholding, sales, use, workers' compensation or unemployment insurance number in Idaho? If yes, list all permit, account or
policy numbers. (It is your responsibility to cancel any existing accounts you no longer need.)
24. List (a) owner and spouse of sole proprietorship, (b) all partners of partnership, (c) all corporate officers of corporation, (d) trustee or responsible party of
fiduciary or trust, or (e) all members of limited liability companies. Social Security number required for every individual listed. (Use additional sheet
If necessary.)
Corp
%
Director?
Compensated?
Name
Address of Residence
SSN/EIN and Phone Number
Title
Owned
Yes/No
Yes/No
CERTIFICATION: I certify that I am authorized as an owner, partner, corporate officer, member or representative to sign this document and that the statements
made are correct and true to the best of my knowledge. (This form must also be signed by the spouse of a sole proprietor.)
Print name____________________________________________ Signature_________________________________________________ Date________
Print name____________________________________________ Signature_________________________________________________ Date________
F
IBR-1
Idaho Business Registration Form
O
Revised
R
2014
EFO00147
Register online at: business.idaho.gov
M
07-01-14
Fax to: (208) 334-5364
IDAHO BUSINESS REGISTRATION
SHADED AREAS FOR STATE USE ONLY
Return to:
PO BOX 36
Account Number
Confirmation No.
BOISE, IDAHO 83722-0410
1a. If LLC, how have you chosen to be
___ Corporation
___ Partnership
___ S Corporation
___ Sole Proprietorship
1. Type of business
taxed for income tax purposes?
Single Member
Corporation
___ Nonprofit
___ Government
___ Fiduciary/Trust
___ Limited Liability Company
(see instructions)
Partnership
S Corporation
___ New applicant
___ Change legal name
___ Change assumed business name (DBA)
2. Purpose of registration
___ Add new account type ___ Add/change location
___ Change in partners, shareholders or managing members ____%
___ Boise Auditorium
___ E911 Prepaid Wireless Fee
___ Travel & Convention
___ Sales
___ Use
3. Apply for permits/accounts
___ Unemployment
___ Withholding
___ Withholding only, no employees working in Idaho
Request more information
___ Amusement Device
___ Beer/Wine
___ Cigarette/Tobacco
4. Federal Employer Identification Number (EIN)
5. Social Security number (SSN)
6. Legal business name (see instructions)
8. Date incorporated
9. State incorporated in
10. Month tax year ends
7. Assumed business name (DBA)
11. Date business began in Idaho
12. Date sales or use
13. Estimated monthly taxable sales
will begin in Idaho
month
year
14. Physical location of
Street address
City
State
Zip Code
business (no PO Box or
mail drop addresses)
15. Mailing address
Street address or PO Box
City
State
Zip Code
Street address or PO Box
City
State
Zip Code
16. Mailing address
for report forms
18. Authorized contact person (name and title) See instructions for definition.
17. Business telephone number
(
)
19. Telephone number & extension of contact person
20. Email address of contact person
21. Fax number of contact person
(
)
22. Primary nature of business: (Specify the product manufactured and/or sold or the type of service performed.)
23. Have you ever had a withholding, sales, use, workers' compensation or unemployment insurance number in Idaho? If yes, list all permit, account or
policy numbers. (It is your responsibility to cancel any existing accounts you no longer need.)
24. List (a) owner and spouse of sole proprietorship, (b) all partners of partnership, (c) all corporate officers of corporation, (d) trustee or responsible party of
fiduciary or trust, or (e) all members of limited liability companies. Social Security number required for every individual listed. (Use additional sheet
If necessary.)
Corp
%
Director?
Compensated?
Name
Address of Residence
SSN/EIN and Phone Number
Title
Owned
Yes/No
Yes/No
CERTIFICATION: I certify that I am authorized as an owner, partner, corporate officer, member or representative to sign this document and that the statements
made are correct and true to the best of my knowledge. (This form must also be signed by the spouse of a sole proprietor.)
Print name____________________________________________ Signature_________________________________________________ Date________
Print name____________________________________________ Signature_________________________________________________ Date________
EFO00147-2
Revised
07-01-14
2014
27. Expected number of Idaho employees
25. Date employees first hired to work in Idaho
26. Date of employees' first paycheck in Idaho
28. Enter the amount of wages you have paid or plan to pay in Idaho. If you haven't paid or don't plan to pay wages during one of the periods listed, enter
"NONE."
Jan. 1 to March 31
April 1 to June 30
July 1 to Sept. 30
Oct. 1 to Dec. 31
Current
Year
Preceding
Year
29. If you estimated wages in #28, enter the date you plan to begin paying wages. _____________________
30. Will corporate officers receive compensation, salary or distribution of profits? ___ Yes
___ No
31. Were you subject to the Federal Unemployment Tax Act during the current or preceding year? ___ Yes
___ No
32. Is this an organization exempt from income tax under Internal Revenue Service Code 501(c)(3)? ___ Yes
___ No
33. Do you want more information about unemployment insurance for nonprofit corporations? (see instructions) ___ Yes
___ No
34. Is workers' compensation insurance needed? (see instructions) ___Yes
___ No, explain why:
CAUTION: This is not an application for workers' compensation insurance
37. Insurance agent's name and telephone number
35. Do you have a workers' compensation
36. Have you notified your insurance company that
you have or expect to have Idaho payroll?
insurance policy?
(
)
___ Yes
___ No ___ In process
___ Yes
___ No
38. Insurance company name
39. Policy number
40. Effective date
41. If applying for insurance with the Idaho State Insurance
Fund, list application number:
42. Do you plan to perform work in other states using your existing Idaho employees? ___ Yes ___ No
If yes, which states? _____________________
WAGE THRESHOLDS LISTED BELOW DO NOT AFFECT AN EMPLOYER'S OBLIGATION TO CARRY WORKERS' COMPENSATION INSURANCE.
43. For most employers:
a) Have you had or will you have 1 or more workers (for any day or portion of a day) in 20 weeks or more in any calendar year? ____ Yes ____ No
b) Have you paid or will you pay $1,500 or more in wages during any calendar quarter? ____ Yes ____ No
c) If yes, indicate the earliest quarter and calendar year. _____________________
quarter
year
44. For agricultural employers only:
a) Have you had or will you have 10 or more workers (for any day or portion of a day) in 20 weeks or more in any calendar year? ____ Yes ____ No
b) Have you paid or will you pay $20,000 or more in cash wages during any calendar quarter? ____ Yes ____ No
c) If yes, indicate the earliest quarter and calendar year. _____________________
quarter
year
45. For domestic help employers only:
a) If you are an individual, local college club, or chapter of a college fraternity or sorority, have you paid or will you pay $1,000 or more in cash
wages in the state of Idaho during any calendar quarter? ____ Yes ____ No
b) If yes, indicate the earliest quarter and calendar year. _____________________
quarter
year
ACQUIRING AN EXISTING BUSINESS OR CHANGING TYPE OF LEGAL BUSINESS ENTITY
If you buy an existing business, or change your business entity, Idaho law requires you to withhold enough of the purchase money to pay any sales tax and, in
most cases, unemployment insurance due or unpaid by the previous owner/entity until the previous owner/entity produces a receipt from the Idaho Department
of Labor and the Idaho State Tax Commission showing the taxes have been paid. If you fail to withhold the required purchase money and the taxes remain
due and unpaid after the business is sold or converted to another entity type, you may be liable for the payment of the taxes collected or unpaid by the former
owner/entity. When there is a change in the legal entity, you must notify your workers' compensation insurance company.
46. Did you acquire all or part of an existing business? ___ All ___ Part ___ None
47. Did you change your legal business entity? ___ Yes ___ No
48. Previous owner's name
49. Business name at time of purchase
50. Date acquired/changed
52. Do you want to receive a form to apply for the unemployment
51. Account/permit numbers of the business acquired/changed
insurance experience rating of your predecessor?
____ Yes ____ No
PUBLICATION CONSENT
53. Yes, I agree to publish my business by category both in print and on the Internet in the Business Directory of Idaho at lmi.idaho.gov and any publication
produced by the Idaho Department of Labor. This will increase visibility of my business to a larger pool of job applicants, will allow my business to be
included when the Department of Labor responds to questions about the availability of products and services in the community, and expand the opportunity
for additional sales. I acknowledge the Idaho Department of Labor's files will be accessed to obtain my company name, address, phone number, NAICS
(industry) code and range of employment.
Signature_______________________________________________________
EIN00059 01-07-14
FORM IBR-1 INSTRUCTIONS — IDAHO BUSINESS REGISTRATION FORM
For faster service, you can register online at: business.idaho.gov
For more help, contact:
Idaho Department of Labor
- 332-3576 in the Boise area or toll free at (800) 448-2977
Idaho Industrial Commission - 334-6000 in the Boise area or toll free at (800) 950-2110
Idaho State Tax Commission - 334-7660 in the Boise area or toll free at (800) 972-7660
All information must be provided or your registration can't be processed.
Instructions are provided only for items that may need clarification.
1. Mark the type of legal business entity. If you have
Using, consuming, or storing items in Idaho on
questions about types of legal business entities,
which you have not paid sales tax. Mark Use.
contact the Idaho Secretary of State, (208) 334-2300.
Withholding only. Mark the box if you have no
employees physically working in Idaho, but you wish
1a. Mark the correct box to indicate how the Limited
Liability Company has chosen to be taxed for income
to withhold Idaho income tax as a convenience to an
tax purposes.
employee whose income is taxable in Idaho, even
though it is earned in another state. Complete all
2. Mark the item(s) that best describes your purpose in
applicable questions through line 28.
filing this form:
• Selling prepaid wireless service. Mark E911
New applicant. If the business is not currently
Prepaid Wireless Fee.
registered with the Idaho State Tax Commission, the
Idaho Industrial Commission, or the Idaho Department
Mark the type of permits or accounts you would like
additional information for:
of Labor.
Operating currency or coin-operated machines
Change legal name. If the business is changing its
used for amusement. For example: video games
legal name, include a copy of proof, i.e. amended
articles of incorporation or federal documentation.
or juke box. Mark Amusement Device.
Change assumed business name. If the business is
• Producing or wholesaling beer. Producing,
distributing, or direct shipping wine. Mark Beer/
changing its assumed business name (DBA).
Wine.
Add new account type. If you already have one of
the permits listed on the application and now need
• Wholesaling, distributing, subjobbing, or delivery
another permit. (Example: You have a sales permit
selling of cigarettes or tobacco. Mark Cigarette/
Tobacco.
and now need a withholding and/or unemployment
account.)
You can find a permit application for amusement
Add/change location. If the business has changed
devices, beer, wine, cigarette, and tobacco at
its physical business location or added other locations.
tax.idaho.gov, or contact the Tax Commission.
Change in partners, shareholders, or managing
4. List your federal Employer Identification Number (EIN)
if one has been issued to you by the Internal Revenue
members. List the percentage of change if
the business has new or additional partners,
Service. If you have employees, or the business is
shareholders, or managing members. Be sure to
other than a sole proprietorship, you must have a
list all of the partners, shareholders, or managing
federal EIN. If you have applied for your EIN, but
members in box 24.
have not received it yet, enter "applied for." If you are
not required to have an EIN, leave this box blank.
Regardless of your purpose in filing this form, the
following boxes must be completed: 1, 2, 3, 4 or 5, 6,
5. Enter your Social Security number if the type of
10, 11, 14, 15, 17, 18, 19, 22, and 24.
business entity is a sole proprietorship.
3. Mark the type of permits or accounts you would like to
6. List the legal name of the business. If the business
is owned by a sole proprietor, list the name shown on
apply for:
the owner's Social Security card.
Employees. Mark Unemployment and Withholding.
If the business is owned by a corporation, limited
Retail sales. Mark Sales.
liability company or partnership, list the legal name as
registered with the Secretary of State.
Renting rooms for 30 days or less. Mark Sales and
7. List the assumed business name (DBA), if different
Travel and Convention.
than the legal business name. (Example: Legal name
Renting rooms in the Greater Boise Auditorium
Karan Jones - DBA Karan's Flowers.) This name
District for 30 days or less. Mark Boise Auditorium.
must also be registered with the Secretary of State,
(208) 334-2301.
FORM IBR-1 INSTRUCTIONS — continued
EIN00059 07-01-14
Page 2
8. If your business is a corporation, enter the date
(e) If you marked Limited Liability Company on
incorporated.
number 1, list the requested information for all
members. If there are more than three members,
9. If your business is a corporation, enter the state in
attach an additional page listing them.
which it was incorporated.
31. The Federal Unemployment Tax Act (FUTA) governs
10. If the business files income tax returns on a calendar
whether a business is subject to paying federal
year basis, enter December. If the business files
unemployment insurance taxes.
income tax returns on a fiscal year basis, enter the
month the business' fiscal year ends.
32. The Internal Revenue Service grants or denies 501(c)
(3) status. The granting of this status doesn't exempt
11. Enter the date this business began operating in Idaho.
a business from unemployment insurance tax, sales
tax, withholding or workers' compensation insurance.
13. Estimate the highest amount of taxable sales the
business will have in any month.
33. The Idaho Department of Labor offers businesses
granted 501(c)(3) status three methods for paying
state unemployment insurance tax liabilities.
14. List the business' physical location in Idaho. If you
have more than one location, attach a separate page
34. If hiring one or more full-time, part-time, seasonal,
listing the additional locations. (Don't use a PO Box
or occasional workers, Idaho law requires that you
or mail drop address.)
obtain a workers' compensation insurance policy
prior to hiring employees unless you are exempt. A
16. If you wish to have the Idaho State Tax Commission
minimum penalty of $25.00 per day can be assessed
report forms mailed to an address different than
against employers who operate without workers'
the one listed on line 15 (such as your accountant's
compensation insurance.
address), list that address.
THIS IS NOT AN APPLICATION FOR INSURANCE.
18. You are authorizing the agencies with which you
YOU WILL NEED TO CONTACT YOUR INSURANCE
register to contact the named individual to discuss
AGENT OR COMPANY REPRESENTATIVE FOR
issues relating to your accounts. In some cases, there
ASSISTANCE.
may be additional Power of Attorney requirements.
If you answer no to this question, explain in detail why
22. Describe in detail the products and/or services your
you believe workers' compensation insurance is not
business in Idaho will provide. (Example: Retail
needed for your business. (Attach additional page if
sales: clothing, food. Agricultural crops: corn, beets.
necessary.)
General contractor: building single-family homes.)
If your business is reorganizing, you must notify your
23. If this business entity or its owner, partners or
workers' compensation insurance carrier of the new
members has ever had a withholding, sales, use,
type of business, including EIN numbers, if applicable.
workers' compensation or unemployment insurance
number in Idaho, list all permits, accounts, or policy
If additional assistance is needed, contact the Idaho
numbers.
Industrial Commission Compliance Division, (208)
334-6000 or by email at suretyrequest@iic.idaho.gov.
24. List the appropriate information:
35-40. If you have already obtained a workers'
If you marked government on number 1, line 24 is
compensation insurance policy, please complete
optional.
boxes 37 through 40.
(a) If you marked Sole Proprietorship on number 1,
If you are in the process of obtaining a workers'
list the requested information for the owner and
compensation insurance policy, complete boxes 37
spouse.
and 38.
(b) If you marked Partnership on number 1, list the
41. If you have applied for insurance with the State
requested information for each partner. If the
Insurance Fund, list the application identification
partner is an individual, list the Social Security
number.
number. If the partner is another business entity,
list the EIN. If there are more than three partners,
46-51. If your business is reorganizing (i.e. you have
attach an additional page listing them.
formed a corporation which has acquired your sole
proprietorship), then you are acquiring an existing
(c) If you marked S Corporation, Corporation, or
business.
Nonprofit on line 1, list the requested information
for each officer. Indicate if the officer is on the
52. By checking that you would like to apply for the
board of directors by writing "yes," "no," or "not
experience rating of your predecessor, you will
applicable" (N/A). If there are more than three
receive another application form to complete. Contact
officers, attach an additional page listing them.
the Idaho Department of Labor for more information.
(d) If you marked Fiduciary/Trust, list the trustees
53. Data is maintained by the Idaho Department of Labor.
or responsible parties. If there are more than
Data can consist of name, address, phone number,
three trustees or responsible parties, attach an
and NAICS (industry) code. Employment figures
additional page listing them.
are published in predetermined size ranges. Exact
employment figures are not published.

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