Fillable Form R-1 Virginia Department of Taxation: Business Registration (Virginia Department of Motor Vehicles)

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Form R-1 Virginia Department of Taxation: Business Registration (Virginia Department of Motor Vehicles)

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Form R-1 Virginia Department of Taxation
Business Registration Form
Go to www.tax.virginia.gov/iReg to register or update your business information online.
Reason for Submitting this Form:
New Business Registration. Complete applicable lines in Sections I, II, IX and all applicable tax types.
Add an Additional Tax Type to Existing Account. Complete applicable lines in Sections I, II, IX and applicable tax types.
Add a New Business Location to Existing Account. Complete applicable lines in Sections I, II, IX and applicable tax types.
Update Contact or Responsible Ocer Information. Complete applicable lines in Sections I, II and IX.
Section I - Business Prole Information
1.
Business Name.
Enter full legal name of business. Sole Proprietors - enter owner’s name (rst, middle initial, last).
2. Federal Employer Identication Number (FEIN). This number is required to register. To obtain a FEIN, contact the IRS.
2a. If Sole Proprietor, enter Social Security Number (SSN) of Owner.
3.
Entity Type.
Check One. See instructions.
SOLE PROPRIETOR (or
single member limited
liability company taxed as an
individual)
ESTATE/TRUST
CORPORATION
C Corporation
Nonprot Corporation
Limited Liability Company
electing to le as a
corporation
PASS-THROUGH ENTITY
S Corporation
General Partnership
Limited Partnership
Limited Liability
Partnership
Limited Liability Company
electing to le as a pass-
through entity
OTHER ENTITY
Nonprot Organization
Cooperative
Credit Union
Bank
Savings and Loan
Public Service
Corporation
GOVERNMENT ENTITY
Federal Government
Virginia State
Government
Local Government
Other State Government
(not Virginia)
Other Government
4.
Trading As Name (or Doing Business As Name).
This is the name known by the public.
5.
Primary Business Activity.
Describe: ____________________________________________________________________________________________
Check if you will be selling any tobacco products.
Check if you intend to operate a retail food establishment, food manufacturing operation, or food warehouse that sells food
products or dietary supplements. Exception: If you intend to operate solely as a restaurant, do not check this box. See
instructions.
6.
Primary Business Address.
Enter the physical address of your business.
Street Address City, State, ZIP
7. Primary Mailing Address. Enter a mailing address if dierent from your Primary Business Address.
Street Address or P.O. Box City, State, ZIP
8.
Primary Contact Information.
Use this section to designate an individual authorized to discuss tax matters on behalf of this
business. The named contact is permitted to resolve specic tax issues and discuss transactions with the Department. See
instructions.
Name Title Contact Phone Number
( )
Va. Dept. of Taxation 1501220 Rev. 04/20
Page 1
FEIN ______________________________________________
Page 2
Section II - Responsible Party
Responsible Party / Corporations and Pass-Through Entities Only - Identify corporate, partnership or limited liability ocers
responsible for tax obligations. See instructions. Providing this information assists Department representatives in verifying authorized
contacts and resolving tax matters.
1.
a) Name of Responsible Party b) SSN
c) Relationship Title d) Relationship Date
e) Home Phone Number (Including Area Code)
f) Residence Address g) City, State, ZIP
2.
a) Name of Responsible Party b) SSN
c) Relationship Title d) Relationship Date
e) Home Phone Number (Including Area Code)
f) Residence Address g) City, State, ZIP
Section III - Annual Tax
A. Corporation Income Tax
1. Date you became liable for Corporation Income Tax (MM/DD/YY).
2. Date and state of incorporation
Date (MM/DD/YY)
State
3. Tax Year. Must be same as your Federal Taxable Year. Check one.
Calendar Year (1/1 – 12/31) or Fiscal Year - Beginning month ____________ and Ending month ___________
or
52-53 Taxable Year - Beginning month ______________ and Ending month _______________
4. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box. City, State, ZIP
5. Subsidiary or Aliate. Complete the following only if this business is a subsidiary or aliated with another business and the
parent is ling a combined or consolidated return.
Combined return. Check if business is a subsidiary or aliate and parent les combined return.
Consolidated return. Check if business is a subsidiary or aliate and parent les consolidated return.
Parent Company’s Business Name Parent Company’s FEIN
6. Contact Information. If dierent from Primary Contact in Section I, enter contact information for person designated for this tax.
Name Title Contact Phone Number
( )
FEIN ______________________________________________
Page 3
B. Pass-Through Entity
1. Date you became liable for reporting Pass-Through Entity Income (MM/DD/YY).
2. Date and state of formation
Date (MM/DD/YY)
State
3. Tax Year.
Must be same as your Federal Taxable Year. Check one.
Calendar Year (1/1 – 12/31) or Fiscal Year - Beginning month ____________ and Ending month ___________
or
52-53 Taxable year - Beginning month ______________ and Ending month _______________
4. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
5. Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
C. Insurance Premiums License Tax
1. Date you became liable for Insurance Premiums License Tax (MM/DD/YY).
2. Insurance Company. If you are an insurance company pending licensure by the Virginia State Corporation Commission
Bureau of Insurance, complete the Insurance Company Section below. Insurance companies must also complete and enclose
the Declaration of Estimated Insurance Premiums License Tax, Form R-1A. Form R-1A is available to download or print on
our website, www.tax.virginia.gov.
Company Type and Company Sub-Type are provided to you by the Bureau of Insurance.
License Number Company Type Company Sub-Type
3. Surplus Lines Broker and Surplus Lines Agency. If a Surplus Lines Broker or Agency, enter producer number below.
Producer Number
4. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
5. Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
Tax Year. Must be same as your Federal taxable year. Check one.
Calendar Year (1/1 – 12/31) or Fiscal Year - Beginning month _________ and Ending month __________
or
52-53 Taxable year - Beginning month _________ and Ending month __________
FEIN ______________________________________________
Page 4
Section IV - Employer Withholding Tax
1. Date you had employees and began paying wages (MM/DD/YY).
2. Filing Frequency.
Will be determined by the Department and reviewed periodically. Indicate below the amount of Virginia
Income Tax you expect to withhold each quarter.
Quarterly Filer - Less Than $300 Virginia Withholding Per Quarter
Monthly Filer - Between $300 and $3,000 Virginia Withholding Per Quarter
Semi-Weekly Filer - $3,000 or Greater Virginia Withholding Per Quarter
Pension Plan Only
Household Employer - Annual Filer
3. Seasonal Business. If open only part of the year,
check months business is active.
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
4. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
5. Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
Section V - Retail Sales and Use Tax
A. In-State Dealers. If your business location is in Virginia, use this area to register for Retail Sales and Use Tax.
1. Date You Became Liable. Anticipated date of rst retail sale (MM/DD/YY).
2. Filing Options. Virginia retail sales businesses with multiple locations, indicate how you will submit your return(s)
.
a. File one combined return for all business locations in the same locality.
b. File one consolidated return for all business locations.
c. File a separate return for each business location.
3. Seasonal Business. If open only part of the year,
check months business is active.
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
4.
Specialty Dealer. Check this box if you sell at ea markets, craft shows, etc. at various locations in Virginia.
5. Business Locations. Complete this section to add a new business location in Virginia whether you are registering for the rst
time or adding a location to your existing account. If adding multiple locations, attach a separate sheet using the same format
as below. A list of FIPS Codes is located at the end of the R-1 Instructions.
a) Add This Location to This Virginia Account Number b) Date Location Opened
c) Trade Name of Business d) Business Locality FIPS Code (Look up at www.tax.virginia.gov/ps)
e) Business Physical Street Address (No P.O. Boxes) City, State, and ZIP
f) Mailing Address (If dierent from above) City, State, and ZIP
6. Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
FEIN ______________________________________________
Page 5
B.
Out-of-State Dealers.
Use this area to register for Retail Sales and Use Tax. Every dealer outside Virginia doing business
in Virginia as a dealer is required to register and to collect and pay the tax on all taxable tangible personal property sold or
delivered for storage, use or consumption in Virginia.
1. Date You Became Liable. Date of rst sale or use in Virginia (MM/DD/YY)
2 Seasonal Business. If open only part of the year,
check months business is active.
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
3. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
4. Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
C. Vending Machine Sales Tax
1 Existing Accounts. Enter Virginia Account Number.
2 Date You Became Liable. Anticipated date of rst retail sale (MM/DD/YY).
3 City or County. Enter the City or County of each location you will operate vending machines (see instructions
).
Location 1 Location 2 Location 3 Location 4 Location 5 Location 6
4 Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
5 Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
D.
Other Sales and Use Tax.
Use this area to register for Sales Type Specic and Use Taxes.
1. Indicate Tax Type(s) & date you became liable (MM/DD/YY). This is the date of the rst sale of a particular product or
service, or the purchase date of the item for use tax purposes.
Tax Type Date You Became Liable Tax Type Date You Became Liable
Consumer Use Tax Date _______________
Watercraft Tax Date _______________
Digital Media Fee Date _______________
Tire Recycling Fee Date _______________
Motor Vehicle Rental Tax Date _______________
Peer-to-Peer Vehicle
Sharing Tax Date _______________
Aircraft Tax Date ____________________
Number of Aircraft Owned
Previous Year: ____________________
Virginia Commercial Fleet
Aircraft License Number: ____________________
2. Seasonal Business. If open only part of the year,
check months business is active.
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
3. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
4. Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
FEIN ______________________________________________
Page 6
Section VI - Communications Tax
A communications service is any electronic transmission of voice, data, audio, video, or other information by or through any
electronic, radio, satellite, cable, optical, microwave or other medium or method regardless of the protocol used for the transmission or
conveyance. Communications services subject to the tax include: landline telephone services (including Voice Over Internet Protocol);
wireless telephone services; cable television; satellite television; satellite radio.
1. Date You Became Liable. Date communications services were provided or anticipated date (MM/DD/YY).
2. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
3. Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
Section VII - Litter Tax
A litter tax is imposed on every business in the state who, on January 1 of the taxable year, was engaged in business as a manufacturer,
wholesaler, distributor, or retailer of certain enumerated products. If you are not in business on January 1, you are not liable for Virginia
Litter Tax until the succeeding year. The products that subject the business to litter tax are: food for human or pet consumption,
groceries, cigarettes and tobacco products, soft drinks and carbonated waters, beer and other malt beverages, wine, newspapers
and magazines, paper products and household paper, glass containers, metal containers, plastic or ber containers made of synthetic
material, cleaning agents and toiletries, non-drug drugstore sundry products, distilled spirits, and motor vehicle parts. This tax does
not apply to individual consumers.
1. Existing Accounts. Enter Virginia Account Number.
2. Date You Became Liable. Date you became liable for Litter Tax (MM/DD/YY).
3. Number of business locations subject to litter tax
4. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
5. Contact Information. If dierent from Primary Contact in Section I enter contact information for this tax.
Name Title Contact Phone Number
( )
FEIN ______________________________________________
Page 7
Section VIII - Commodity and Excise Taxes
1. Tax Type - See instructions. Indicate tax type and the date you became liable. (MM/DD/YY).
Cattle Assessment Date ____________
Corn Assessment Date ____________
Cotton Assessment Date ___________
Egg Excise Tax Date ____________
Forest Products Tax Date ____________
Peanut Excise Tax Date ____________
Soybean Assessment Date ____________
Small Grains Assessment Date ____________
Soft Drink Excise Tax Date ____________
Sheep Assessment Date ____________
2. Mailing Address if dierent from the Mailing Address in Section I.
Street Address or P.O. Box City, State, ZIP
3. Contact Information. If dierent from Primary Contact in Section I, enter contact information for this tax.
Name Title Contact Phone Number
( )
Section IX - Signature
IMPORTANT - READ BEFORE SIGNING
This registration form must be signed by an ocer of the corporation, limited liability company or unincorporated association, who
is authorized to sign on behalf of the organization. The proprietor must sign for a sole proprietorship.
Under penalty of law, I believe the information on the application to be true and correct.
Signature Title
Print Name Date Daytime Phone Number
( )
For assistance with this form, or for information about taxes not listed in this form, please call (804) 367-8037.
Fax the completed form to (804) 367-2603 or mail it to: Virginia Department of Taxation
Registration Unit
P.O. Box 1114
Richmond, VA 23218-1114
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Form R-1 Virginia Department of Taxation: Business Registration (Virginia Department of Motor Vehicles)

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Completed 11 May 2021

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