Form Reg-1 - Illinois Business Registration Application Page 3
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4Step 5: Describe your business
1
Check all that apply to your Illinois business activity.
___ Retail
___ Wholesale
___ Service
___ Manufacturing/production
2
Check all that apply to your type of business.
Not-for-profit business/organization
Advertising, business services
Furniture, flooring, appliances
Nursery, florists, garden supplies
Auto supplies
Gasoline, other petroleum products
Other manufacturing not listed: ___________
Books, jewelry, gifts, cameras
Grocery items
Other retail not listed: ________________
Building trades, construction, contractors
Hardware
Other services not listed: ______________
Clothing and accessories
Homes - mobile/modular
Other wholesale not listed: ____________
Coin-operated amusement devices
Hotel/motel
Paper, textiles, printing, chemicals
Communication
Leasing/renting equipment
Pharmaceuticals/drug stores
Computers/programming/design/software
Liquor
Public administration, government
Dental, medical services/facilities
Lumber, building materials
Real estate, insurance, finance
Dept. store/general merchandise
Machines, parts, equipment
Renting vehicles
Drinking places
Mail order, direct/vending sales
Sporting goods, bicycles, toys
Eating places
Medical supplies
Tobacco products
Electric
Metals, rubber, plastic
Transportation
Electronics, TVs, music, instruments
Mining, coal, other minerals
Vehicles, boats, motorcycles
Forestry, livestock, agriculture, fishing
Natural gas
Water, sewer
Step 6: Identify your business location
Do not complete this step unless your location is in Illinois and your business activities include sales (including vehicle sales), use, service,
hotel/motel operations, telecommunications, motor vehicle renting, electricity services, natural gas, or liquor warehousing. Write your
business name, address (even if it is the same as identified in Step 3), and the date the location started doing business. Note: Township
information is required for all Madison or St. Clair County locations in Illinois.
❍
❍
Location 1:
Is this the same address as the address in Step 3?
yes
no
Check all that apply to this location’s type of activity.
Sales, Use, Service
Motor vehicle renting
Telecommunications
Electricity services
Vehicle sales
Liquor warehousing
Hotel/motel operator
Natural gas
Name:__________________________________________________________________
Starting date:______________
Doing business as (DBA) or trade name if different from the name you provided in Step 3
Month Day
Year
_______________________________________________________________________________________________________
Street address (Do not use PO Box), include apartment or suite number (if applicable)
Illinois
_______________________________________________________________________________________________________
City
State
ZIP
County: _______________
Township: ________________
______________
Ext:_____
_________________
Daytime phone (include area code)
Fax (include area code)
a
Check the best physical description of this location:
permanent
one that will change ( e.g., fairs, flea market)
b
Check the best description of this location in regards to the city, village, or town limits listed above:
inside
outside
Location 2:
Check all that apply to this location’s type of activity.
Sales, Use, Service
Motor vehicle renting
Telecommunications
Electricity services
Vehicle sales
Liquor warehousing
Hotel/motel operator
Natural gas
Name:__________________________________________________________________
Starting date:______________
Doing business as (DBA) or trade name if different from the name you provided in Step 3
Month Day
Year
_______________________________________________________________________________________________________
Street address (Do not use PO Box), include apartment or suite number (if applicable)
Illinois
_______________________________________________________________________________________________________
City
State
ZIP
County: _______________
Township: ________________
______________ Ext:_____
_________________
Daytime phone (include area code)
Fax (include area code)
a
Check the best physical description of this location:
one that will change ( e.g., fairs, flea market)
permanent
b
Check the best description of this location in regards to the city, village, or town limits listed above:
inside
outside
Additional locations:
Check if you need to identify more locations. Attach a separate sheet containing all of the required information in a similar format.
Tell us your total number of Illinois locations. ____________
(REG-1 N-1/00)
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