Business Type Reason for Registration
Corporation
Non-Profit
Courtesy withholding for an employee's resident municipality
S-Corp Estate & Trust Doing business within the municipality this year (temporary)
LLC
Sole Proprietor / LLC Approx. # of days Start Date
Partnership
Business with a fixed location
Company Information
(List physical address of work performed within this municipality)
Name: Federal ID #:
Address:
SSN :
City/State/Zip:
Mailing Address
(for withholding tax forms / if different from above)
Mailing Address
(for net profit tax forms / if different from above)
Filing Status:
Calendar year Fiscal year / month ending
Do you have any employees? Yes No
Number of employees at RITA location
My withholding is filed under a 3rd party account (PEO or common paymaster)
Monthly gross payroll at RITA location $
I am a small employer (under $500,000 in gross revenue during previous year)
Contractors
I am a contractor Yes No
Will you be using sub-contractors?
Total contract amount of the project $
The Information Hereby Submitted is True and Correct.
Phone Number
/ /
*Please note that your Federal Identification Number will serve as your RITA account number.
Municipality
Date business began at this location
(required if sole proprietor)
No
If yes, list Federal ID #
No
Yes
No
If yes, complete page 2.
Print Name
Title
Date
Please complete and sign this Registration Form and return within 10 business days. Please be advised that failure to timely register with RITA may result in delays in the
processing of any required income tax filings or may result in future penalty and interest charges, if applicable. If you have any questions please contact the Registration
Department at the number below.
Signature
ritaohio.com
Call: 800.860.7482, ext. 5008
TDD: 440.526.5332
Fax: 440.922.3536
Mail to: RITA
ATTN: BUSINESS REGISTRATION
P.O. BOX 477900
BROADVIEW HEIGHTS, OH 44147-7900
FORM
48
Regional Income Tax Agency
Business Registration Form
Access ritaohio.com to register electronically using MyAccount. Login to
MyAccount to Add a Municipality or Add Subcontractor. These features allow
you to report a new location or new subcontractor project electronically.
PRINT FORM
RESET FORM
$
$
$
$
$
EIN or Social Security #
Trade
Sub-contractor Name / Address
Contact Name
Contract Amount
Phone Number
Estimated Start Date
EIN or Social Security #
Trade
Sub-contractor Name / Address
Contact Name
Contract Amount
Phone Number
Estimated Start Date
EIN or Social Security #
Trade
Sub-contractor Name / Address
Contact Name
Contract Amount
Phone Number
Estimated Start Date
EIN or Social Security #
Trade
Sub-contractor Name / Address
Contact Name
Contract Amount
Phone Number
Estimated Start Date
EIN or Social Security #
Trade
Sub-contractor Name / Address
Contact Name
Contract Amount
Phone Number
Estimated Start Date
Sub-contractor Name / Address
$
Contact Name
Contract Amount
Phone Number
Estimated Start Date
EIN or Social Security #
Trade
*If more space is needed, you may attach a separate schedule that includes ALL of the required information listed above.
Mail to: RITA
ATTN: BUSINESS REGISTRATION
P.O. BOX 477900
BROADVIEW HEIGHTS, OH 44147-7900
Call: 800.860.7482, ext. 5008
TDD: 440.526.5332
Fax: 440.922.3536
ritaohio.com