Form Nj Reg - Business Registration Application - 2010 Page 3
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3NJ-REG
FEIN: ______________________________ NAME: _____________________________________
(8-06)
Each Question Must Be Answered Completely
11. a. Will you collect New Jersey Sales Tax and/or pay Use Tax? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
GIVE EXACT DATE YOU EXPECT TO MAKE FIRST SALE ___________/__________/__________
Month
Day
Year
b. Will you need to make exempt purchases for your inventory or to produce your product? . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
c. Is your business located in (check applicable box(es)):
Atlantic City
Salem County
North Wildwood
Wildwood Crest
Wildwood
d. Do you have more than one location in New Jersey that collects New Jersey Sales Tax? (If yes, see instructions) . . . . . .
Yes
No
e. Do you, in the regular course of business, sell, store, deliver or transport natural gas or electricity to users or customers
in this state whether by mains, lines or pipes located within this State or by any other means of delivery? . . . . . . . . . . . .
Yes
No
12. Do you intend to sell cigarettes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Note: If yes, complete the REG-L form on page 45 in this booklet and return with your completed NJ-REG.
To obtain a cigarette retail or vending machine license complete the form CM-100 on page 47.
13. a. Are you a distributor or wholesaler of tobacco products other than cigarettes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
b. Do you purchase tobacco products other than cigarettes from outside the State of New Jersey? . . . . . . . . . . . . . . . . . . . .
Yes
No
14. Are you a manufacturer, wholesaler, distributor or retailer of “litter-generating products”? See instructions for retailer . . . . . .
Yes
No
liability and definition of litter-generating products.
15. Are you an owner or operator of a sanitary landfill facility in New Jersey? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
IF YES, indicate D.E.P. Facility # and type (See instructions) _____________________________________
16. a. Do you operate a facility that has the total combined capacity to store 200,000 gallons or more of petroleum products? . .
Yes
No
b. Do you operate a facility that has the total combined capacity to store 20,000 gallons
(equals 167,043 pounds) of hazardous chemicals? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
c. Do you store petroleum products or hazardous chemicals at a public storage terminal? . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Name of terminal ___________________________________________________________________________
17. a. Will you be involved with the sale or transport of motor fuels and/or petroleum? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Note: If yes, complete the REG-L form in this booklet and return with your completed NJ-REG.
To obtain a motor fuels retail or transport license complete and return the CM-100 in this booklet.
b. Will your company be engaged in the refining and/or distributing of petroleum products for distribution in this State or
the importing of petroleum products into New Jersey for consumption in New Jersey? . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
c. Will your business activity require you to issue a Direct Payment Permit in lieu of payment of the Petroleum Products
Gross Receipts Tax on your purchases of petroleum products? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
18.
Will you be providing goods and services as a direct contractor or subcontractor to the state, other public agencies
including local governments, colleges and universities and school boards, or to casino licensees?
. . . . . . . . . . . . . . . . . . .
Yes
No
19.
Will you be engaged in the business of renting motor vehicles for the transportation of persons
or non-commercial freight? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
20.
Is your business a hotel, motel, bed & breakfast or similar facility and located in the State of New Jersey? . . . . . . . . . . . . . .
Yes
No
21. Do you hold a permit or license, issued by the New Jersey Department of Transportation, to erect and maintain
Fee expired effective 7/1/07
an outdoor advertising sign or to engage in the business of outdoor advertising? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22.
Do you make retail sales of new motor vehicle tires, or sell or lease motor vehicles? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
23.
Do you provide "cosmetic medical procedures" or goods or occupancies directly associated with such procedures? . . . . . . .
Yes
No
(See description of Cosmetic Procedures Gross Receipts Tax in the list of Taxes of the State of New Jersey, page 5.)
Type of Business___________________________________________________
24.
Do you sell voice grade access telecommunications or mobile telecommunications to a customer with a primary
place of use in this State? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
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Will you make retail sales of "fur clothing"? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
.
(See full description of Fur Clothing Retail Gross Receipts Tax in the list of Taxes of the State of New Jersey, page 5)
26. Contact Information:
Person ___________________________________________________ Title: _______________________________
Daytime Phone: (
) ________ - ________________ Ext._______
E-mail address: ______________________________________
Signature of Owner, Partner or Officer: _________________________________________________________________________________
Title ____________________________________________________________________________ Date: _________________________
NO FEE IS REQUIRED TO FILE THIS FORM
IF YOU ARE A SOLE PROPRIETOR OR A PARTNERSHIP WITHOUT EMPLOYEES - STOP HERE -
IF YOU HAVE EMPLOYEES PROCEED TO THE STATE OF NJ NEW HIRE REPORTING FORM ON PAGE 29
IF YOU ARE FORMING A CORPORATION, LIMITED LIABILITY COMPANY, LIMITED PARTNERSHIP, OR A LIMITED
LIABILITY PARTNERSHIP YOU MUST CONTINUE ANSWERING APPLICABLE QUESTIONS ON PAGES 23 AND 24
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