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ADDITIONAL BUSINESS LOCATIONS AND/OR RENTAL PROPERTY OWNED
Attach additional sheet(s) if needed)
(
BUSINESS NAME
BUSINESS DESCRIPTION
ADDRESS
STATE/PROV
ZIP/POSTAL CODE
CITY
OR
CHECK ALL THAT APPLY
THIS IS AN ADDITIONAL
RENTAL PROPERTY OWNED,
OWNED RENTAL PROPERTY
# OF UNITS: ______________
BUSINESS LOCATION
COMMERCIAL
RESIDENTIAL
BUSINESS NAME
BUSINESS DESCRIPTION
ADDRESS
STATE/PROV
ZIP/POSTAL CODE
CITY
OR
CHECK ALL THAT APPLY
RENTAL PROPERTY OWNED,
OWNED RENTAL PROPERTY
THIS IS AN ADDITIONAL
BUSINESS LOCATION
# OF UNITS: ______________
COMMERCIAL
RESIDENTIAL
INSTRUCTIONS: New businesses are required to register with the City of Portland and Multnomah County. Existing
businesses changing their tax entity, and sole proprietors/single-member LLCs reopening their business should also
complete this form and provide their Business License Tax account number. The business name, taxpayer ID #, entity
type, etc. should match the federal/Oregon tax return on which the single-member LLC’s income is directly reported.
Single-member LLCs should not register or file in the LLC’s name. The name of the single-member LLC should be
included on the “Doing Business As” line. Spouses who jointly file their IRS/Oregon individual tax return are required to
file a joint City/County return as well. Only one Registration Form should be completed. Include the name and SSN of
the second spouse in the OWNERS AND/OR PARTNERS section of this form. Most information is subject to disclosure
under Public Record Law.
NO PAYMENT IS DUE WITH THIS FORM
To remain in compliance you must file a City/County tax return
EACH YEAR when you file your federal and state returns.
All required forms may be found at
NOTICE OF CONFIDENTIALITY
All tax returns and related financial information, including a Taxpayer ID #, filed with the City of Portland are
confidential. Except as provided by PCC 7.02.230, .240, and .250, it is unlawful to divulge or release any
information submitted or disclosed to the City.
SIGNATURE
The undersigned declares under penalty of making a false statement, that the information given in this form is true.
____________________________________________________
_____________________________________
_______________________
Signature of Registrant or Authorized Representative
Title
Date
MAIL or FAX completed form to: City of Portland, 111 SW COLUMBIA, SUITE 600, PORTLAND OR 97201 ~ FAX: 503-823-5192
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OFFICIAL USE ONLY
Date Received
Entry Date
NAICS