For Office Use Only 
                                                                                                                                                                  
                                                                                                                                                                 Acct#   ___  ___  ___  ___  ___  ___ 

                                                                                                  City of Chicago 
                                                                                                  Tax Division 
                                                          DePaul Center Room 300 
                                                                                                  333 S. State Street 

                                                                                                  Chicago, IL 60604 
                                     ( Please Do Not Send Any Payments With This Form ) 
                                                                                                           
   FOR TAX PURPOSES ONLY – DO NOT USE THIS FORM IF YOU ARE REQUIRED TO HOLD A 
                                                      CHICAGO BUSINESS LICENSE 
                                                                                                           
             New Accounts Information Sheet – Corporations/Partnerships/LLC’s etc. 
                      (This Form is not required if this Corp./Partnership etc. currently or previously has held a City of Chicago Business license.) 
                                                                                                           
                                        ( Bold Faced Items are required to begin the processing of your application. ) 
 
1.  What is the Legal Name of your _________Corporation, __________Partnership, _________ Limited Partnership, _________LLC  or  
   _________Not-For-Profit Corporation? 
 
2.     What is the Doing Business As (DBA) name or your entity (if different than Legal Name)?* 
 
*(If different you must apply for an Assumed Name at 118 N. Clark St. Lower Level Chicago, IL 60602 (312) 603-5652) 
                     
3. FEIN #                    -                                                                                                             4. In which State did you Incorporate             
 
5. Date of Incorporation (for Corp or LLC) ____/____/____                           6. State of Ill. File #                                                                                
  
7. State of Ill. Exemption # (for non-profits)   E                                                                                                           Exp. Date ________/________/________ 
 
8. Illinois Business Tax (IBT) Number**                                                           -   
            
                                      (needed if goods are sold or if you have employees other than yourself on your payroll) 
             **If you do not have a current IBT# you may obtain one from the Ill. Dept. of Revenue at 100 W. Randolph St. (7 THFloor) (217 ) 785-3707 
                                                                                                           
9.  Do you employ 50 or more individuals whose work is located in Chicago          Yes     /      No                (Circle One) 
 
10.  Do you rent out or lease tangible items which are used in Chicago         Yes     /        No                       (Circle One) 
 
11. Describe your business’s activities?  Please mention all products or services you offer. 
 
     ________________________________________________________________________________________________________________ 
 
     ________________________________________________________________________________________________________________ 
 
     ________________________________________________________________________________________________________________ 
 

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         Corporate Vice-President /                 Partner  /            Other _____________________________________          Ownership Percentage   ___________% 
 
________________________________________________     _____________    ______________________________________________________   ___________ 
                                      First Name                                               Middle Init.                                                 Last Name                                                         Jr./Sr. 
 
__________________________     _________    ____________________________________________________________   _____________    ________________ 
               Street Number                       Dir.                                                 Street Name                                                                  Rd, Ave etc.          Suite / Floor# 
 
_____________________________________________________       _________________       __________________       __________________________________ 
                                                    City                                                                     ST                                Zip Code                                        E-Mail Address 
 
(_____________)       __________________  -  _________________________                  
                                         Phone Number                                                                                                                   
 
__________ / __________ / __________                                                                                                           
 
                      D a t e  o f  B ir t h                                                                                                                             
 
Note: If you are purchasing a business in the City of Chicago, you are required per section 3-4-140 of the Uniform Revenue 
Procedures Ordinance to file a Bulk Sales Notification.   
 
If you have any questions regarding this form please call 312-747-4747 or for TTY dial 312-742-1974.  Email this document  
when completed to RevenueDatabase@cityofchicago.org   
                                                       
                                                    Or you can fax your completed document to: 
                                                           312-747-1890 
                                                       Attn: Database Unit 
                                                            
                                                  Or you may mail your completed document to: 
                                                            
                                                    Chicago Department of Finance 
                                                       333 S. State Street Room 300 
                                                          DePaul Center 
                                                          Chicago, IL 60604 
                                                       Attn: Database Unit