Form Fr-500 - Combined Business Tax Registration Application
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4COMBINED BUSINESS TAX
GOVERNMENT OF THE DISTRICT OF COLUMBIA
FR-500
OFFICE OF TAX AND REVENUE
REGISTRATION APPLICATION
PART I — GENERAL INFORMATION
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1(a). Federal Employer Identification Number
2. NAICS Business Code
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1(b). Social Security Number
3. Reason for application: (please check)
4. Legal form of business (please check):
New business
Employment of household/domestic help
Sole proprietor
Limited partnership
Additional location
Address change
Limited Liability Company
Government
Purchased existing business
Merger (attach merger agreement)
General partnership
Joint venture
Name change
Other (describe on an
Limited liability partnership
Other (specify)
(if a corporation, attach corporation amendment)
attachment)
Corporation
Legal form change
Heating oil company
If incorporated, enter state and date of incorporation
Street vendor
Utility company
State _________________ Mo. _____ Day _____ Yr _____
5. Business Name (Individual, Partnership, Corporation)
6. Trade Name (if different from Line 5)
7. Business Address (P.O. Box is not acceptable unless located in a Rural Area)
8. Mailing Address
9. Local Business Phone No.
10. Main Office Phone No.
10(a). Fax No.
11. Date present business began in D.C.
or date expected to begin
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)
Mo. ________ Day ________ Year ________
12. If previously registered with the District of Columbia, please indicate:
Former Entity Name __________________________________________ Business Tax Registration Number ___________________________________
Former Trade Name ___________________________________________ Name of Former Owners __________________________________________
13. NAME, TITLE, HOME ADDRESS, SOCIAL SECURITY NUMBER OF PROPRIETOR, PARTNERS OR PRINCIPAL OFFICERS
Name and Title
Home Address
Zip Code
Social Security Number
Email Address
Name and Title
Home Address
Zip Code
Social Security Number
Email Address
Name and Title
Home Address
Zip Code
Social Security Number
Email Address
PART II — Franchise Tax Registration
14. Indicate your profession, principal business activity or service (for example, retail grocery, wholesale auto parts, barber shop, doctor, contractor, land-
scaper, etc.)
15. Do you or will you have an office, warehouse, or other place of business in the District of Columbia, or a representative
with a D.C. location?
Yes
No
16. Do you or will you have merchandise stored in a public or private warehouse in D.C.?
Yes
No
17. Do you or will you perform in D.C. personal services (medical, accounting, consulting); or other services such as
electrical, heating, construction, etc., or installations or repairs of any type?
Yes
No
18. Do you or will you generate any business related income from D.C. sources?
Yes
No
19. Do you or will you have rental property in D.C.?
Yes
No 20. Date converted or expected to be converted to rental property ____/____/____
21. Date on which your taxable year ends:
Month ________ Day ________ Year ________
22. Describe fully ALL your current or expected business activities and/or major type of services performed within D.C.
(Attach separate sheet if necessary.)
(Rev. 3/03)
— INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED AND WILL BE RETURNED —
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