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             Illinois Department of Revenue

             REG-3-C   Business Information Update
Step 1:          Read this information first
Complete the following information to update your registration information. Submit REG-3-C via email to Rev.CRD@illinois.gov, mail to Illinois 
Department of Revenue, P.O. Box 19030,  Springfield, Illinois, 62794-9030, or fax to 217 785-6013.

Step 2:          Identify your current business 
 1       Business name                                                                                                        4 FEIN or SSN: 
 
 2                                                                                                   5 (      )                                 - 
         Number and street                      City                           State         ZIP       Phone
 3       Email address

Step 3:  Discontinuation or sale of entire business - If you sold your business, Form CBS-1, Notice of Sale, Purchase, or
                 Transfer of Business Assets, may be required. Visit our website at tax.illinois.gov for more information. 
 6       Effective date:  

Step 4:  Change business name - If your FEIN has changed due to a name change, you must complete a new Form REG-1,
                 Illinois Business Registration Application.  For a copy or to register on-line, visit our website attax.illinois.gov. 
 7       Previous legal business name:                                            New legal business name: 
 
 8       Previous DBA name:                                                       New DBA name: 
           
Step 5:  Change current address
a        Legal address - Effective date: 
 9                                                                                                     11   (                                )     - 
         Number and street                      City                        State   ZIP                     Phone

 10      County                                                                                         12  Township

b        Mailing address - Effective date: 

13                                                                                                     16   (                                )     - 
         Number and street                      City                        State   ZIP                     Phone

14   In care of name
 
15       Identify the taxes affected by this change   Sales and use taxes and fees                       Motor fuel and related taxes
            Marketplace Facilitator                  Motor vehicle renting tax                          Unemployment insurance
            Withholding income tax                           Excise taxes and fees - Identify tax/fee:  _______________________________
            Other:  __________________________       All taxes and fees

Step 6:  Add a location - Effective date:                                           Complete Schedule REG-1-L, Illinois Business Site Location 
                 Information, to add more than one location. For a copy or to add a location on-line, visit our website at tax.illinois.gov. 

17                                                                                                     20   (                                )     - 
         Number and street                      City                        State   ZIP                     Phone
18       Check the best physical description of this location:                  permanent                  temporary  (e.g., fairs, flea market)
19       Is the address outside the city limits?                               yes                        no 

Step 7:  Close a location - Date this location closed: 
                 If closing more than one location, attach a separate sheet following the same format as below including the date closed.

21 
          Number and street                     City                           State        ZIP  

 22  County                                                                      23    Township

REG-3-C (R-05/24)

 Step 8:  Change owner or officer information  
 24      Individuals - Social Security Numbers (SSN) required:
    a                                                                                                                                                         c                                                                            
            Name                                                                   Title                                                                                Name                                                                 Title
                                                                                                                                                                                                                                                                  
            Home address - PO Box not accepted                 City                                State           ZIP                                                  Home address - PO Box not accepted                  City                                State         ZIP
                                                                     (            )               -                                                                                                                             (          )              -                                                     
            Date of birth                                            Phone                                                                                              Date of birth                                           Phone 
                                                                    Ownership percentage:                                                                                                                                      Ownership percentage:                                                         
            Social Security number                                                                                                                                      Social Security number
    b                                                                                                                                                        d                                                                             
            Name                                                                   Title                                                                                Name                                                                 Title
                                                                                                                                                  
            Home address - PO Box not accepted                 City                                State            ZIP                                                 Home address - PO Box not accepted                  City                                State         ZIP
                                                                     (            )               -                                                                                                                             (          )              -                                                      
            Date of birth                                            Phone                                                                                              Date of birth                                           Phone 
                                                                     Ownership percentage:                                                                                                                                      Ownership percentage: 
            Social Security number                                                                                                                                      Social Security number

 25     Businesses  - Federal Employers Identification Numbers (FEIN) required
        a                                                                                                                                                     b                                                                              
           Name                                                                    FEIN                                                                               Name                                                                   FEIN                                                            
                                                                                                                                                            
           Legal  address                                                                                                                                             Legal  address                                          
                                                                                                                                                             
           City                                                                                                State                         ZIP                      City                                                                                                State                         ZIP 
           (        )                         -                          Ownership percentage:                                                                        (          )                         -                     Ownership percentage: 
           Phone                                                                                                                                                      Phone    

 Step 9:  Remove owners, officers, and responsible parties
 26  Complete the following information (including the Social Security number) if you need to remove an owner, officer, or responsible party from the    
         Department’s registration records.
    a                                                                                                                                                        b                                                                            
           Name                                                                    Title                                                                                 Name                                                                 Title 
                                                                    (             )              -                                                                                                                              (          )              -                                                        
           Date of birth                                            Phone                                                                                                Date of birth                                          Phone   
                                                                                                                                                                                                                                                             
           Social Security number                                                Date ceased                                                                             Social Security number                                              Date ceased

 27      Identify the taxes affected by this change                                        Sales and use taxes and fees                                                                Motor fuel and related taxes  
            Marketplace Facilitator                                                          Motor vehicle renting tax                                                                Unemployment insurance 
            Withholding income tax                                                            Excise taxes and fees - Identify tax/fee:  _______________________________ 
            Other:  __________________________                                               All taxes and fees

 Step 10:  Identify a contact person regarding your business
 28  Name:                                                                                                                                                Title: 

 29  (            )                -                                                                (                                              )                -                                      
         Phone                                                                                       Fax                                                                                                     Email address 

 Step 11: Comments
        ____________________________________________________________________________________________________
        ____________________________________________________________________________________________________
        ____________________________________________________________________________________________________

 Step 12: Sign below
         Under penalties of perjury, I state that I have examined this information and, to the best of my knowledge, it is true, correct, and complete. 

        Signature:                                                                                Title:                                                                                                             Date:
          
                                                                                                               (                                            )                  - 
         Printed name                                                                                                            Phone
                  This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this information is required. Failure to provide
                  information may result in this form not being processed and may result in a penalty Printed by the authority of the State of Illinois REG-3-C (R-05/24) Web only - One copy 
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