Form Cr 0100 Web - Colorado Business Registration - 2006
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3Department Use Only
CR 0100 Web (03/01/06)
1375 Sherman Street
COLORADO BUSINESS REGISTRATION
Denver CO 80261-0009
(303) 238-SERV (7378)
PLEASE PRESS FIRMLY AND PRINT CLEARLY - INSTRUCTIONS FOR THIS FORM ARE IN THE PUBLICATION CR 101
1. REASON FOR FILING THIS APPLICATION
THE REVERSE SIDE
Original Application
Change of Ownership
OF THIS PAGE
Do you have a Dept of Revenue Account Number?
Yes
No
IF Yes, Account # _______________________________________
MUST BE COMPLETED
Do you want this number assigned to new location?
Yes
No
2. Indicate Type of Organization
Estate
Other Non-Profit
Individual
Limited Liability Limited
Government
Partnership (LLLP)
General Partnership
Joint Venture
Other
Trust
Limited Partnership
Corporation
Limited Liability Company (LLC)
'S' Corporation
Non-profit 501 (C)(3)
Limited Liability Partnership (LLP)
Association
(Please enclose copy of the IRS letter of exemption.)
SIDE A
1. Taxpayer Name (Owner, Partners or Corporate Name) (Last, First, Middle)
2a. Trade Name/Doing Business As (If Applicable)
2b. Federal Employer Identification Number (FEIN)
3a. Street Address of Principal Place of Business in Colorado
City
State
ZIP Code
B
3b. County
If business is within limits of a city, what city?
Telephone
(
)
4a. In Care Of (C/O)
4b. Mailing Address (If Different From Above) (Include Unit #)
City
State
ZIP Code
Telephone
(
)
5. Bank Name (If Available)
Bank Address
Bank Account Number
6. First Day of Payroll (Mo/Day/Yr)
Payroll Records Location (List Address )
Payroll Records Telephone
(
)
7. What products and/or services do you provide? (Complete Section "H")
Do you sell motor vehicle tires?
Yes
No
Is your business in a special taxing district?
Yes
No
Do you rent out items for 30 days or less?
Yes
No
8a. Owner/Partner/Corp. Officer
Title
Social Security #
Federal Employer Identification Number (FEIN)
8b. Address (Residence or P.O. Box, Street, City, State, ZIP Code)
Telephone
(
)
9a. Owner/Partner/Corp. Officer
Title
Social Security #
Federal Employer Identification Number (FEIN)
9b. Address (Residence or P.O. Box, Street, City, State, ZIP Code)
Telephone
(
)
If you acquired the business in whole or in part, complete the following:
10a. Prior Taxpayer Name
Date of Acquisition
Prior Taxpayer UI Tax Account Number
10b. Address
City
State
ZIP Code
Apr.
Jan.
July
Oct.
Period Covered
E – FEES
If Seasonal, mark
1.
Feb.
Nov.
May
Aug.
each business month.
From
To
Sept.
Mar.
June
Dec.
(0020-
Mo
Mo
State Sales Tax
2a. Filing Frequency: If sales tax collected is:
2b. First Day of Sales (Mo/Day/Yr)
Deposit
(355) $
810)
$15.00/month or less - Annually
Yr
Yr
Under $300/month - Quarterly
Mo
Mo
(0080-
Sales Tax
Revenue Registration Account Number
$300/month or more - Monthly
License
(999) $
750)
Yr
Yr
Wholesale only - Annually
Mo
Mo
(0100-
Wholesale
3. Indicate which applies to you:
License
(999) $
750)
Yr
Yr
Wholesaler
Charitable
RTD
(Mo/Day/Yr) _________________________________
Mo
Mo
(1000-
Wage
Retail-Sales
CD
0.00
Event Location _______________________________
Withholding
(999) $
750)
Retailers-Use
FD
Yr
Yr
(0160-
Mo
Mo
1. Filing Frequency: If wage withholding amount is
2. Oil/Gas
D
Charitable
License
(999) $
750)
Yr
$1 - $6,999/Year - Quarterly
Withholding
Yr
$50,000+/Year - Weekly
Make check payable to
Must file by Electronic Funds Transfer
TOTAL $
$7,000 - $49,999/Year - Monthly
•
Colo. Dept. of Revenue
Both White Pages Must Be Returned.
I declare under penalty of perjury in the second degree that the statements made in this application are true and complete to the best of my knowledge.
SIGNATURE of Owner, Partner, or Corporate Officer Required
Title
Date
OFFICE USE ONLY
Account Type
NAICS
Org
LC
LD
QD
SC
IA
Sig
N
TR-1
Date
Tech Sig
SEE PAGE 3 FOR RETURN CHECK POLICY
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