Form Reg-3-C - Request For Change In Business Information

Illinois Department of Revenue

REG-3-C

Request for Change in Business Information

Step 1: Read this information first

Complete the following information if you need to change your registration information. If you need to change business information

for more than one business location, you must complete a separate Form REG-3-C for each location. If you have questions,

contact us at 217 785-3707.

Step 2: Tell us the reason you are completing this form - check only one

❒ ❒ ❒ ❒ ❒

1

Business discontinued. Tell us the date you discontinued your business: ____/____/________

❒ ❒ ❒ ❒ ❒

Sold my business - Tell us to whom and when: ______________________________________

____/____/________

The options below pertain to only active businesses. Do not check any of these if you are no longer in business.

❒ ❒ ❒ ❒ ❒

Change in Doing-business-as name (DBA) - Complete Step 3, Line 4 with your new DBA.

❒ ❒ ❒ ❒ ❒

Changes to my address ( e.g., ZIP code, suite number)

❒ ❒ ❒ ❒ ❒

Adding a location

❒ ❒ ❒ ❒ ❒

Closing a location

❒ ❒ ❒ ❒ ❒

Change in officers

❒ ❒ ❒ ❒ ❒

Other. See Step 8.

Step 3: Identify your business

2

__________________________________________________________

3

IBT no.: ___ ___ ___ ___ - ___ ___ ___ ___

Business name

Illinois Business Tax number

4

__________________________________________________________

5

FEIN:___ ___ - ___ ___ ___ ___ ___ ___ ___

Doing-business-as name (DBA), if applicable

Federal Employer Identification number

Step 4: Change your business’ address - skip this Step if there is no change in your address

__________________________________________________________

____________________________________

Number and street

City, State, ZIP

______________________________ __________________________

(_____)_____ - __________

County

Township

Telephone

Date this became effective: ____/____/_____

Step 5: Add a location

__________________________________________________________

____________________________________

Number and street

City, State, ZIP

______________________________ __________________________

(_____)_____ - __________

County

Township

Telephone

Date this became effective: ____/____/_____

C

heck the best physical description of this location:

one that will change ( e.g., fairs, flea market)

permanent

Check the best description of this location in regards to the city, village, or town limits listed above:

inside

outside

Step 6: Close a location

__________________________________________________________

____________________________________

Number and street

City, State, ZIP

______________________________ __________________________

(_____)_____ - __________

County

Township

Telephone

Date this became effective: ____/____/_____

This form is authorized by 20 ILCS 687/6-1 et seq.; 35 ILCS 5/1 et seq., 105/1 et seq., 110/1 et seq., 115/1 et seq., 120/1 et seq., 130/1 et seq., 135/1 et seq., 143/10-1 et seq., 145/1 et seq., 155/1 et seq., 173/5-1 et

seq., 505/1 et seq., 510/1 et seq., 615/1 et seq., 620/1 et seq., 625/1 et seq., 630/1 et seq.; 35 ILCS 635/1 et seq., 636/5-1 et seq., 640/2-1 et seq.; 230 ILCS 20/1 et seq., 25/1 et seq., 30/1 et seq.; 235 ILCS 5/1-1 et

seq.; 305 ILCS 20/1 et seq.; 415 ILCS 125/301 et seq. Disclosure of this information may be REQUIRED. Failure to provide information could result in this form not being processed and possible penalties. This form has

been approved by the Forms Management Center. IL-492-4448

(N-10/05)