Form Ar-1r - Combined Business Tax Registration Form
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7AR-1R
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ARKANSAS DEPARTMENT OF FINANCE AND ADMINISTRATION
Combined Business Tax Registration Form
PO Box 8123 Little Rock, AR 72203-8123
Read instructions carefully before completing this form. For assistance call (501) 682-1895. Register a new business online using ATAP at
REASON FOR SUBMITTING THIS FORM
New Business -
Add Additional
Add Additional
Ownership
ATAP
Check One:
Never Registered
Location
Tax Type
Change
Third Party Access
SECTION A - TAX TYPES
Type of Registration: (Check all that apply)
Sales and Use
Dyed Diesel
Liquor
Catfish Feed
Construction
Withholding Wage
Brine Severance
Wine
Corn/Grain Sorghum
Telecommunications
Withholding Pass Through
Natural Gas Severance
Cigarette
Rice
Merchandise Vending
1.
Withholding Pension
Oil Severance
Cigarette Papers
Soybean
Amusement
Corporation Income
Timber Severance
Other Tobacco Products
Wheat
Bingo/Raffle
Partnership Income
Other Severance
Soft Drink
Brucellosis/Pseudorabies
Beauty Pageant
Motor Fuel
Beer
Beef
Waste Tire
SECTION B - OWNER INFORMATION
Ownership Type: (Check only one)
Corporation
Partnership
LLC
Government
Fiduciary / Trust
Non-Profit
-
Federal Identification Number (FEIN): (Required)
2.
OR
Sole Proprietor
-
-
Social Security Number: (Required)
Owner's Name: (Enter full legal name of Business. If you selected Sole Proprietor owner type, enter first name, middle name, and last name.)
3.
DBA: (Enter full Doing Business As Name, if applicable.)
4.
Primary Business Activity: (Enter the NAICS code that best matches your business (see instructions) and describe your business activity.
5.
a) NAICS
b) Brief Description
Physical Location Address
a) Street (Not PO Box)
b) Unit
c) Phone Number: (Include Area Code)
6.
f) State
g) Zip Code
d) City
e) County
Mailing Address
a) In Care Of
b) Street Address or PO Box
7.
d) State
e) Zip Code
c) City
Revised 01/29/2013
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Parent category: Financial