Form 637 - Application For Registration (For Certain Excise Tax Activities)

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637
Application for Registration
Form
OMB No. 1545-0014
(For Certain Excise Tax Activities)
(Rev. December 2013)
Department of the Treasury
Information about Form 637 and its instructions is at
Internal Revenue Service
Part I
Identification of Applicant
Name of individual, corporation, partnership, association, etc.
Employer identification number
Business name, if different from above
Telephone number
Mailing address (number, street, and room or suite no.; if P.O. box, see instructions)
Fax number
City or town, state, and ZIP code
If you listed a P.O. box above, or if your street address is different from your mailing address, list your street address (including city or town, state, and ZIP code)
Part II
Activities.
Enter the activity letter from the chart on pages 2–4 and a brief description of each activity for which you are applying
for registration. Also, attach the Additional Information Required for each activity to which this application applies.
Activity Letter
Activity Description
Part III
General Information
Section A—For All Applicants
Answer all the questions below. Attach a separate sheet(s), as needed, to answer items 2b through 7. Identify each sheet with your
name and employer identification number (EIN) at the top, and write the number of the item to which each answer applies. If any
questions do not apply to you, explain why.
1 a Are you or will you be required to file Form 720, Quarterly Federal Excise Tax Return?
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Yes
No
b Have you previously applied to be registered by any IRS office? .
Yes
No
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c Have you, or any related entity, had a Certificate of Registry or Letter of Registration revoked by any IRS
office? .
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Yes
No
d If you answered “Yes” to b or c, enter the name of the IRS office
2 a List the date your business started
Month
Year
b Explain in detail your business activity.
3
For all other business entities to which you are related, list:
a The name and EIN of the related entity,
b The percentage of ownership, and
c How you are related (for example, stock, partnership, etc.).
4
List all addresses of current business operations (include out-of-state or foreign operations, if applicable).
5
List the address where your books and records are kept (if different from the address in Part I).
6
List the names and taxpayer identification numbers (TINs) of all business owners, corporate officers, members, or partners.
7
List the name and phone number of a person whom we can contact about this application.
Section B—For All Fuel Applicants
If you are applying for fuel activities K, M, S, X, Y, AB, AF, AL, AM, CC, NB, SB, UA, UB, UP, or UV, you must answer questions
8 and 9.
Attach a copy of your last federal income tax return and other evidence that reflects financial responsibility such as your
8
income statement, balance sheet, or bond rating.
9
Describe any changes in your ownership or changes of controlling stock ownership in the past 2 years. If none, enter “None.”
Also see Changes in Registration in the instructions.
Go to Section C on Page 2
637
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form
(Rev. 12-2013)
Cat. No. 49952H

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