Form Nc-Br - Business Registration Application For Income Tax Withholding, Sales And Use Tax, And Machinery And Equipment Tax
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Business Registration Application for
NC-BR
Income Tax Withholding, Sales and Use Tax,
Web-Fill
Office Use
1-15
and Machinery and Equipment Tax
North Carolina Department of Revenue
1.
Federal Employer ID No.:
or
Proprietor’s Social Security No.:
-
-
-
2. Type of Ownership:
Other (Identify)
Proprietorship
Corporation
LLC
Partnership
LLP
Fiduciary
If a corporation, state of incorporation:
If Corporation or LLC, enter N.C. Secretary of State ID No., if applicable:
3. Legal Business or Owner’s Name:
4. Trade Name (DBA Name):
5. Daytime Business Phone:
6. Fax Phone:
Street
7. Business Location in N.C.:
(Not P.O. Box Number)
State
City
Zip Code
County
8. Is the business located within city or town limits?
9. Number of locations in N.C.
Enclose list if more than one.
Yes
No
10. Mailing Address:
Street or P.O. Box
State
City
Zip Code
11. List responsible persons (President, Treasurer, Chief Financial Officer, Manager, Primary Partners, other officers, etc.):
Title
Social Security No.
Address
Name
Complete to apply for an Income Tax Withholding Number.
-Do you have employees who are subject to N.C. withholding?
Yes
No
-Date when wages were or will first be paid in N.C.:
(You are required to file a return beginning with the month or quarter you indicate.)
-Do you make pension payments to N.C. residents?
Yes
No
If yes, do you choose to report the pension payment withholding separately? (See instructions)
Yes
No
-Do you pay compensation (other than wages to employees) to a nonresident entity or a nonresident individual for personal services performed
in N.C.?
Yes
No
Yes
No
-Do you pay compensation (other than wages) to an ITIN contractor for services performed in N.C.?
-Total amount you expect to withhold each month:
Less than $250 (Quarterly)
$250 - $2,000 (Monthly)
more than $2,000 (Semiweekly)
-If business is seasonal (six or fewer monrths),
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
fill in circles for months employees are paid:
Complete to apply for a Sales and Use Tax Number.
(You are required to file a return beginning
-When will you start selling or purchasing items subject to N.C. sales or use tax?
with the month or quarter you indicate.)
-Will your sales or gross receipts be?
Retail
Wholesale
Both Retail and Wholesale
(to users or consumers)
(to registered merchants for resale)
-What kind of business are you engaged in? (Be specific)
-What accounting method will you use?*
Cash
Accrual
-Are you registering only to remit use tax on purchases?
Yes
No
-Will you provide and sell piped natural gas?
Yes
No
-Will you provide and sell telecommunications services?
Yes
No
-Will you provide and sell electricity?
Yes
No
-Will you provide and sell direct-to-home satellite services?
Yes
No
-Will you lease motor vehicles to others?
Yes
No
-Will you provide and sell other video programming services?
Yes
No
-Will you sell new tires?
Yes
No
-Will you provide and sell prepaid wireless
Yes
No
telecommunications services?
-Will you sell new appliances?
Yes
No
-Amount of sales tax expected each month:
Less than $100 (Quarterly)
$100 - $20,000 (Monthly)
More than $20,000 (Monthly with Prepayment)
-If business is seasonal (six or fewer monrths),
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
fill in circles for months of sales:
*Sales tax on telecommunications services and electricity must be reported on the accrual basis.
IV. Machinery and Equipment Tax Section -
Complete to apply for a number to remit tax on purchases of machinery and equipment.
-Are you registering to remit tax on purchases of machinery and equipment to operate a manufacturing industry or plant,
Yes
No
certain recycling purchases by a major recycling facility, or other items subject to tax pursuant to Article 5F?
-When will you begin making these purchases?
V. Signature:
Title:
Date:
I
certify that, to the best of my knowledge, this application is accurate and complete.
Mail to: N.C. Department of Revenue, P. O. Box 25000, Raleigh, NC 27640-0100
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