Fillable Business Registration Form (City of Pittsburgh)

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Business Registration Form (City of Pittsburgh)

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City of Pittsburgh
Department of Finance
414 Grant Street Room 207
Pittsburgh, PA 15219
Assistance? Call: (412) 255-2543
Email: registration@pittsburghpa.gov
Fax: (412) 255-6821
Business Registration Form
Complete this form to create a business account with the City of
Pittsburgh. The City will assign your business a nine digit account
number. This form will not be processed or considered complete until
this form is signed and dated.
Section 1: Reason For Submitting Form
1. Federal Identification Number* ______________________ 2. Social Security Number* ________________________
*Provide IRS 9 digit number assigned to your business & IRS EIN documentation
*Enter Owner, Primary Officer or Partner's SSN
Sole Proprietor
Limited Liability Company (LLC)
One Member Only
Two or More Members
Cooperative
Estate or Trust
Joint Venture
Partnership
General Partnership
Limited Liability Partnership (LLP)
Limited Partnership (LP)
S Corporation
C Corporation
Non-Profit * (provide IRS documentation)
Charitable Non-Profit* (provide IRS documentation)
Association
Other - Specify Below
6. Business Start Date ___________________
7. First Day of Business Activities in Pittsburgh _________________
8. Enter the six-digit NAICS code(s) that best describes your business activities (enter at least one) __________________
If you do not know your NAICS code, go to https://www.naics.com/search/ to search.
9. Describe your business activities below, including the type of industry - manufacturing, services, retail or wholesale
trade, etc. Also describe the nature of business being done in the City of Pittsburgh. List additional NAICS codes here:
Section 3: Business Address and Contact Information
1. Pittsburgh Business Location and/or Home Based Employee Address - If there is more than one address, please attach on a separate sheet
Street Address
City
State
Zip
Code
2. Mailing Address -All correspondence is sent to this address. If you would like your CPA/accountant to receive your tax forms please list address on separate sheet.
Street Address
City
State
Zip
Code
3. Business Phone Number
4. Fax Number
5. Email Address
6. List INDIVIDUALS who are owners, officers, and members. (REQUIRED). Note: Partnerships, LLPs and multi-member
LLCs must have at least 2 owners/officers/individuals listed. Attach a separate sheet if necessary.
CITY ID #:
6A. Name (last name, first name, middle initial)
Social Security Number
Address (street, city,state, zip code)
Title
6B. Name (last name, first name, middle initial)
Social Security Number
Address (street, city,state, zip code)
Title
Page 1 of
3
Rev. 11/19
3. Full Legal Name of Business (name associated with IRS FEIN) : __________________________________________________
4. Trade Name (doing business as), if any: _______________________________________________________________
5. Indicate Type of Business Structure: (For Non-Profit selections, IRS determination letter must be included)
New Business
Change in Business Structure or Business Name - *Change in Business Status Form must be completed by the previous owner(s) and
attached.
Purchased Existing Business
Other - Please describe reason for submitting form ______________________________________________________
_______________________________________________________________________________________________
Section 2: Business Information
Continue to Section 4 on Page 2
Phone Number
Phone Number
PARKING ID #:
Section 4: City Tax Liabilities
Local Services
Tax
Payroll Expense
Tax
Amusement Tax
Parking Tax
Institution &
Service Privilege
Tax
Non-Resident
Sports Facility
Usage Fee
Section 5: Additional Parking Tax Information
1. Operator's Name (last name, first name)
2. BBI Permit Number
3. Property Owner's Name (last name, first name)
4. Property Owner's Telephone Number
8. Check ALL that apply to your parking location below:
Rev. 11/19
Page 2 of
3
5. Property Owner's Address
City
State
Zip Code
6. Parking Lot/ Garage Location*
Address should be identical to the one appeared on your Parking Permit and Application with the Bureau of Building Inspection
7.
Former Operator's Name
Surface Lot
Garage
Automatic Ticket-Spitter
Manually Issued Tickets
Computerized Reporting System
Leased Spaces Only
10. Number of Free Spaces
11. How often does the rate change?
*ONLY complete this section if you are liable for Parking tax
City of Pittsburgh Tax Types
9. Max. Vehicle Capacity
Continue to Section 5 on Page 3
A tax on individuals for the privilege of engaging in an occupation. The tax may be levied, assessed and collected by the
political subdivision of the taxpayer's primary place of employment. If the registrant is employed full time elsewhere, and the
LST is being withheld, you MUST provide a copy of the paystub or W-2 that indicates LST.
Every employer doing business in the City of Pittsburgh is required to pay a Payroll Tax on the gross payroll expense and on
net distribution from self-employed individuals, members of partnerships, associations, joint ventures or other entities who
perform work or provide services within the City of Pittsburgh. The ordinance imposes a Payroll Tax on all businesses that
engage, hire, employ or contract with one or more individuals to perform work or render services within the City of Pittsburgh.
All places of amusement and all producers of amusements are required to collect tax from the patrons and remit the collected
taxes to the City of Pittsburgh. If the entity is a charitable non profit performing arts, please provide a current copy of the Federal
990 tax return, Non profit Charter, and PA sales and use tax certificate of exemption with the completed registration.
All persons or entities within the City of Pittsburgh who park or store motor vehicles for a consideration are required to register
and collect the Parking Tax from patrons.
Entities engaged in service in the medical, education, social, recreational, vocational or any other type of services where there is
a charge collected, except elementary and secondary schools, are required to pay gross receipts. Exception is receipts from the
sale of food, drink, or merchandise.
Every employer who employs one or more non-resident employee who earns compensation as a result of services performed at
a publically funded facility within the city, to engage in an athletic event or otherwise render performance for which a non-
resident receives remuneration is required to withhold and remit the fee to the Treasurer as result of services performed at a
publicly funded facility within the city.
Business Registration Form
Complete this form to create a business account with the City of
Pittsburgh. The City will assign your business a nine digit account
number. This form will not be processed or considered complete
until this form is signed and dated.
City of Pittsburgh
Department of Finance
414 Grant Street Room 207
Pittsburgh, PA 15219
Assistance? Call: (412) 255-2543
Email: registration@pittsburghpa.gov
Fax: (
412) 255-6821
Payroll Expense Tax
Parking Tax
Local Services Tax
Amusement Tax
Non-Resident Sports Facility Usage Fee
Institution & Service Privilege Tax
1.Type of Taxes
Check ALL of the business taxes you expect or are required to pay and/or collect:
For more information on City taxes, please visit our Finance website at:
http://pittsburghpa.gov/finance/tax-descriptions
For questions contact: Call Tax Payer Services at (412) 255-8822 or Email: taxcompliance@pittsburghpa.gov
CITY ID #:
Employer Withheld Wage Tax: Please Contact Jordan Tax Service - (412) 345-7968 (www.jordantax.com/Act32/Employer.html) to register for a
withholding account for the Earned Income Tax.
PARKING ID #:
(Non-Profit Entities Only )
City of Pittsburgh
Department of Finance
414 Grant Street Room 207
Pittsburgh, PA 15219
Assistance? Call: (412) 255-2543
Email:
registration@pittsburghpa.gov
Fax: (412) 255-6821
Business Registration Form
Complete this form to create a business account with the City of
Pittsburgh. The City will assign your business a 9 digit account number.
This form will not be processed or considered complete until this form is
signed and dated.
Section 6: Signature (REQUIRED)
I, the undersigned, do hereby affirm that this official government document has been examined by me and to the
best of my knowledge and belief, is true, correct and complete.
1. Signature of Owner / Officer
2. Print Full Name
3. Date Signed
4. Phone Number
5. Title
Submission of Business Registration Form
After completing and signing this business registration form, please submit your registration to:
1. Email : registration@pittsburghpa.gov
2. Mail to : Registration, City of Pittsburgh
414 Grant Street Room 207
Pittsburgh, PA 15219-2476
For Office Use ONLY:
Select Application Type:
Rev. 11/19
Page 3 of 3
12. Please List Weekly Hourly Rates
13. Please List Fixed Rates
14. Please List Weekend Rates
16. Please List Lease Rates
17. Other
*Please specify below
Fixed/Flat Rate _______________
Early Bird Rate _______________
Night Rate _______________
Event Rate _______________
Saturday ______________
Sunday ______________
Lease Rates _____________
Monthly _____________
15. Please List Current Night Rates
Daily ______________
Monthly _____________
Hourly ______________
1-1 _____________
2-2 _____________
3-3 _____________
CITY ID #:
3-4 _______________
4-5 _______________
5-6 _______________
6-7 _______________
7-8 _______________
8+ _______________
PARKING ID #:
Continued Section 5: Additional Parking Tax Information
TAXPAYER IS REQUIRED TO NOTIFY CITY OF PITTSBURGH WHEN RATES CHANGE
*ONLY complete this section if you are
liable for Parking Tax
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Business Registration Form (City of Pittsburgh)

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Completed 17 December 2020

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