Form Ibr-2 - Idaho Business Registration

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Revised
IBR-2
5 - 1 9 - 9 9
1 9 9 9
Return to:
IDAHO STATE TAX COMMISSION
PO BOX 36
BOISE, IDAHO 83722-0036
SHADED AREAS FOR STATE USE ONLY
___Sole Proprietorship
___Partnership
___S Corporation
___Corporation
1 .
Type of business
___Nonprofit
___Government
___Fiduciary/Trust
___Limited Liability Company
___New business
___Change legal name
___Add new permit type
Purpose of registration
2 .
___Change business name
___New location
___Change in partners or shareholders _____%
___Sales
___Boise Auditorium
3 a . Date sales or use
Type of permit/account
3 .
will begin in Idaho
___Use
___Travel & Convention
3b.
Amusement device decals
Number of decals requested __________ X $35.00 = _________Total Due
4 .
Federal employer identification number (EIN)
5. Social security number (SSN)
6 .
Legal business name (see instructions)
7. Assumed business name (DBA)
8 .
Date business began
9. Date incorporated
10. State incorporated in
11. Month tax year ends
Physical location of
C o u n t y
1 2 .
City
State
Zip Code
Street address
business (no PO Box or
mail drop addresses)
City
State
Zip Code
1 3 .
Mailing address
Street address or PO Box
1 4 .
Mailing address
State
Zip Code
Street address or PO Box
City
for report forms
16. Contact person (name and title)
17. Telephone number of contact person
1 5 .
Business telephone number & extension
(
)
(
)
1 8 .
Primary nature of business in Idaho: (describe product/service)
1 9 . Did you previously have a withholding, sales or use, number in Idaho? If yes, list all permit, account or policy numbers.
2 0 .
List (a) owner and spouse of sole proprietorship, (b) all partners of partnership, (c) all corporate officers of corporation or, (d) all members of
limited liability companies (Use additional sheet if necessary.)
Corporate
Director?
Address of Residence
SSN or EIN and Phone Number
N a m e
% Owned
Title
Yes/No
CERTIFICATION:
I certify that I am authorized as an owner, partner, corporate officer, member or representative to sign this document and that the
statements made are correct and true to the best of my knowledge.
Print name_______________________________________________ Signature___________________________________________________
Date___________
Print name_______________________________________________ Signature___________________________________________________
Date___________
Complete Page Two
Mail complete registration to: Idaho State Tax Commission, PO Box 36, Boise, ID 83722-0036

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