Fillable Business Tax Account Application 83t513.fd2 (Office of Innovation and Technology)

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Business Tax Account Application 83t513.fd2 (Office of Innovation and Technology)

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The Business Tax Account Application 83t513.fd2 (Office of Innovation and Technology) form is 3 pages long and contains:

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  • 4 check-boxes
  • 101 other fields

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File type: PDF

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BROWSE OFFICE OF INNOVATION AND TECHNOLOGY (PA) FORMS

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DEPARTMENT USE ONLY
PHILADELPHIA BUSINESS TAX ACCOUNT NUMBER
-
PHILADELPHIA COMMERCIAL ACTIVITY LICENSE NUMBER
REVENUE CODE 3702
3. DO YOU NEED PRIOR YEAR TAX FORMS?
YES NO
4. DATE WAGES FIRST PAID
--
5. TAXABLE MONTHLY PAYROLL
$,,.00
6A. PRIMARY TYPE OF BUSINESS
CONSTRUCTION WHOLESALE RETAIL MANUFACTURING SERVICES OTHER
6B. DESCRIBE EXACT TYPE OF BUSINESS
7. ENTITY NAME
8. TRADE NAME (IF APPLICABLE)
9. BUSINESS ADDRESS (NUMBER AND STREET. DO NOT USE P.O BOX NUMBERS.)
11. BRANCH OFFICE ADDRESS, IF ANY. (IF MULTIPLE LOCATIONS, ATTACH SEPARATE SHEET.)
RENTOWN
10. MAILING ADDRESS (IF DIFFERENT FROM BUSINESS ADDRESS.)
12. BUSINESS TELEPHONE NUMBER
13. HOME TELEPHONE NUMBER 14. FAX NUMBER 15. E-MAIL ADDRESS
16. TYPE OF ORGANIZATION (CHECK ONE)
A
)
SOLE PROPRIETOR
D)
GENERAL PARTNERSHIP
LIMITED PARTNERSHIP
LIMITED LIABILITY PARTNERSHIP
B)
CORPORATION
ESTATE/TRUST
Check here if any
member is a corporation.
Check here if
any member
is a corporation.
C)
SOLE PROPRIETORSHIP
CORPORATION PARTNERSHIP
WAGE TAX ONLY
G) I)GOVERNMENT H) ASSOCIATION
NON-PROFIT UNDER INTERNAL REVENUE CODE §501 (C) (3)
(ATTACH COPY OF THE IRS EXEMPTION LETTER.)
17. INDIVIDUALS, PARTNERS OR OFFICERS NAMES
18. HOME ADDRESS 19. SSN OR FEDERAL EIN
RACE/NATIONAL ORIGIN:
WHITE
A
SIAN, PACIFIC ISLANDER
OTHER (SPECIFY):
BLACK HISPANIC
SEX:
MALE FEMALE
20A. VOLUNTARY DISCLOSURE OF RACE AND GENDER INFORMATION 20B. PRIMARY LANGUAGE OF BUSINESS OWNER
ENGLISH SPANISH KOREAN
RUSSIAN OTHER (SPECIFY):
I understand that if I knowingly make any false statement(s) herein, I am subject to penalties as prescribed by law.
SIGNATURE
PRINT NAME PHONE NUMBER DATE
Mail the completed application to the CITY OF PHILADELPHIA, DEPARTMENT OF REVENUE, P.O. BOX 1600,
PHILADELPHIA, PA 19105-1600 or FAX to 215-686-6635. If submitting by fax, do not
mail this form.
F)
JOINT VENTURE
E)
PARTNERSHIP
LIMITED LIABILITY COMPANY (LLC)
If Disregarded Entity, enter the City account
number of the parent company_______________
RENTOWN
DISREGARDED ENTITY (LLC)
READ INSTRUCTIONS ON REVERSE BEFORE COMPLETING THIS FORM
CLEARLY PRINT OR TYPE ALL INFORMATION
You can register online at https://www.ework.phila.gov/revenue
There is no fee for a Commercial Activity License.
YOU MUST ENTER YOUR FEDERAL EMPLOYER
IDENTIFICATION AND/OR SOCIAL SECURITY NUMBER
EMPLOYER IDENTIFICATION NUMBER
-
SOCIAL SECURITY NUMBER
--
PA STATE SALES and USE TAX NUMBER
-
1B. IF THIS ACCOUNT IS FOR NET PROFITS TAX ONLY, CHECK HERE:
1A. IF THIS ACCOUNT IS FOR WAGE TAX WITHHOLDING ONLY, CHECK HERE:
2A. DATE PHILADELPHIA BUSINESS BEGAN
--
2B. ARE YOU CLAIMING "NEW BUSINESS" TAX STATUS
UNDER PHILADELPHIA CODE 19-3800?
NOYES
CITY STATE ZIP CODE
CITY STATE ZIP CODE
CITY STATE ZIP CODE
APPLICATION FOR
PHILADELPHIA BUSINESS TAX ACCOUNT NUMBER
COMMERCIAL ACTIVITY LICENSE
WAGE TAX WITHHOLDING ACCOUNT
CITY OF PHILADELPHIA
Bus. Tax App. Page 1 Ver.05.15.2020
0
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Block number:
1A and 1B. If this account is for Wage Tax or Net Profits Tax only, check the appropriate box.
2A and 2B. Indicate the exact date taxable Philadelphia business activity began in the spaces provided.
If you are claiming "New Business" tax status under Philadelphia Code 19-3800 you must complete
Page 2 of this application.
3. If
you indicate "YES" on the front of the application, the appropriate tax returns will be mailed to you.
4.
In
dicate the exact date for which wage tax was first withheld in the spaces provided.
5. Y
our taxable monthly payroll will determine if you remit wage tax quarterly, monthly, semi-monthly or weekly.
6A. Check one box only to indicate your primary
type of business.
6B. Indicate the exact
type of business, e.g., manufacturing children's clothing, retail plumbing supplies, wholesale
grocery items, etc.
7. Indicate your entity name.
8
.
If
you operate your business under a different name than in Block 7, enter here.
9. Enter
your business address. Do not use a Post Office Box number as your business address. Indicate if you
ow
n the property. If you own the property used for business purposes and it is located within Philadelphia,
you will also be liable for Business Use and Occupancy tax.
10
. Enter
your primary mailing address if different from the business address. Do not use a Post Office Box number as
your business address.
11
. Br
anch locations would include any business location from which you are paying taxes, such as non-Philadelphia
re
tail establishments that withhold wage tax from Philadelphia residents. Do not use a Post Office Box number as
y
our branch office address.
12 through 15. Indicate daytime information.
16. Check the appropriate organization.
Department of Revenue Information: Department of Licenses and Inspections Information:
PHO
NE: 215-686-660
0 PHO
NE: 215-686-2463
E-MAIL: revenue@phila.gov E-MAIL: license.issuance@phila.gov
INTERNET: www.phila.gov/revenue INTERNET: www.phila.gov/li
83-T-5 (Reverse) Rev.12-31-2013
INSTRUCTIONS
A Commercial Activity License is required for business conducted in Philadelphia. The license is free. If box 1A,
1B, 16G, 16H or 16I is checked, a Commercial Activity License is not required. You may apply for an account
number online at www.phila.gov/revenue.
» Your Federal Employer Identification Number must be entered on this application.
» A Social Security Number must be entered for a Sole Proprietorship.
» Enter the Pennsylvania Sales and Use Tax license number.
17 through 19. If additional space is needed, attach a separate sheet. Corporate officers and partners must include their
Social Security number in Block 19; corporate partners must include the EIN of the corporation.
20A and 20B. The information requested is on a voluntary basis only. You are not required to furnish this information, but
are encouraged to do so. If your entity is a partnership or a corporation, please check the boxes that apply
to the majority owner or owners.
Page 2
City of Philadelphia
New Business Tax Status
Philadelphia Code 19-3800
Bus. Tax App. Page 2 Ver.05.15.2020
Applicant's EIN/SSN:
Complete this page if you are seeking status as a new business under Philadelphia Code 19-3800 which exempts the business
from paying Business Income & Receipts Tax for the first two years of operation.
Section A - Eligibility
1. Is this a reactivation of an existing Business Income & Receipts Tax account that has been active within the last five years?
2. Is this a business affiliated with or sharing substantial common ownership or control with a business that has filed
a Business Income & Receipts Tax return?
3. Is this a business created through an ownership change of a business that has filed a Business Income & Receipts
return including but not limited to:
a) A merger, acquisition, or reorganization?
b) The transfer of an existing business to a person who maintains the same or substantially similar business?
c) The closing of a business and its subsequent reopening as the same or similar business?
4. Is this business primarily engaged in holding, selling, leasing, transferring, managing or developing real estate?
Yes: No:
Yes: No:
Yes: No:
Yes: No:
If you answered yes to any of the above questions you do not qualify for new business tax status under Philadelphia Code 19-3800.
Section B - Employment Requirements
1. Do you agree to employ at least three full-time employees who are not family members and who work at least
sixty percent of their time in the City of Philadelphia within the first 12 months of your business start date and
continuously thereafter through the 18th month of your start date?
2. Do you agree to employ at least six full-time employees who are not family members and who work at least
sixty percent of their time in the City of Philadelphia from the 18th month of your start date through the 24th
month of your start date?
Yes: No:
Yes: No:
If you answered no to either question you do not qualify for new business tax status under Philadelphia Code 19-3800.
If you answered yes to both questions you will automatically be registered for a wage tax account and be subject to
wage tax filing requirements.
Applicant's Name:________________________________ Applicant's Signature:_______________________________
Date:____________ Telephone Number:______________________ E-mail Address:___________________________
If you initially qualify for new business tax status and subsequently fail to meet the employment requirements set forth
in this section you will retroactively be subject to the full Business Income & Receipts Tax, including interest and
penalty charges from the start date of business.
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Business Tax Account Application 83t513.fd2 (Office of Innovation and Technology)

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Completed 18 July 2020

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