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                    City of Pittsburgh 
                    Department of Finance                                             Business Registration Form
                    414 Grant Street Room 207 
                    Pittsburgh, PA 15219                                              Complete this form to create a business account with the City of 
                                                                                      Pittsburgh. The City will assign your business a nine digit account 
                    Assistance? Call:  412 255-2543(     )                            number. This form will not be processed or considered complete until 
                    Email: registration@pittsburghpa.gov                              this form is signed and dated. 
                    Fax:  412 255-6821    (  )                                                                                                  CITY ID #:
                                                                                                                                    PARKING ID #:
Section 1: Reason For Submitting Form
     New Business
     Change in Business Structure or Business Name - *Change in Business Status Form must be completed by the previous owner(s) and 
     attached. 
     Purchased Existing Business 
     Other - Please describe reason for submitting form ______________________________________________________   
     _______________________________________________________________________________________________ 
Section 2: Business Information
1. Federal Identification Number*  ______________________    2. Social Security Number*  _______________________                                                                      _
*Provide IRS 9 digit number assigned to your business & IRS EIN              documentation             *Enter Owner ,Primary Officer or          Partner's SSN
3. Full Legal Name of Business (name associated with IRS FEIN) : __________________________________________________
4. Trade Name (doing business as), if any:  _______________________________________________________________
5.Indicate Type of Business Structure:    (For Non-Profit selections  IRS determination,           letter must be included)
     Sole Proprietor                                       Limited Liability Company (LLC)                                          Non-Profit  *  (provide IRS documentation)
     Partnership                                                           One Member Only                                          Charitable Non-Profit *(provide IRS documentation)
           General Partnership
                                                                           Two or More Members                                      Association
           Limited Liability Partnership (LLP)
            Limited Partnership                (LP)                   Cooperative                                                   Other - Specify Below
     S Corporation                                                    Estate or Trust
                            C Corporation                  Joint Venture       
6. Business Start Date  ___________________                                  7. First Day of Business Activities in Pittsburgh _________________
8. Enter the six-digit NAICS code(s) that best describes your business activities (enter at least one) __________________
   If you do not know your NAICS code, go to https://www.naics.com/search/ to search.
9. Describe your business activities below, including the type of industry - manufacturing, services, retail or wholesale
trade, etc. Also describe the nature of business being done in the City of Pittsburgh. List additional NAICS codes here:

Section 3: Business Address and Contact Information
1. Pittsburgh Business Location and/or Home Based Employee Address -                                            If there is more than one address,please attach on a separate sheet 
Street Address                                             City                                                               State                     Zip Code

2. Mailing Address -All correspondence is sent to this address. If you     would like your CPA/accountant to receive your tax forms please list address on separate sheet             .
Street Address                                             City                                                             State                       Zip Code

3. Business Phone Number                                   4. Fax Number                                                    5. Email Address

6. List INDIVIDUALS who are owners, officers,                         and members.          (REQUIRED) Note:        .             Partnerships, LLPs and multi-member 
LLCs must have at least 2 owners/officers/individuals listed. Attach a separate sheet if necessary.
6A. Name (last name, first name, middle initial)                                                Phone Number                                    Social Security Number

Address (street, city,state, zip code)                                                                                      Title

6B. Name (last name, first name, middle initial)                                                   Phone Number                                 Social Security Number

Address (street, city,state, zip code)                                                                                      Title

Rev. 11/19

                                                           Continue to Section 4 on Page 2                                                                                    Page 1 of 3



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                                City of Pittsburgh 
                                Department of Finance                                       Business Registration Form
                                414 Grant Street Room 207 
                                Pittsburgh, PA 15219                                        Complete this form to create a business account with the City of 
                                                                                            Pittsburgh. The City will assign your business a nine digit account 
                                Assistance? Call:  412 255-2543(     )                      number. This form will not be processed or considered complete 
                                Email: registration@pittsburghpa.gov                        until this form is signed and dated. 
                                Fax:  412 255-6821( )                                                                                             CITY ID #:
                                                                                                                                          PARKING ID #:
Section 4: City Tax Liabilities

                                                                       City of Pittsburgh Tax Types
         Local Services                   A tax on individuals for the privilege of engaging in an occupation. The tax may be levied, assessed and collected by the 
                  Tax                     political subdivision of the taxpayer's primary place of employment. If the registrant is employed full time elsewhere, and the 
                                          LST is being withheld, you MUST provide a copy of the paystub or W-2 that indicates LST.
                                          Every employer doing business in the City of Pittsburgh is required to pay a Payroll Tax on the gross payroll expense and on 
         Payroll Expense                  net distribution from self-employed individuals, members of partnerships, associations, joint ventures or other entities who 
                  Tax                     perform work or provide services within the City of Pittsburgh. The ordinance imposes a Payroll Tax on all businesses that 
                                          engage, hire, employ or contract with one or more individuals to perform work or render services within the City of Pittsburgh.
                                          All places of amusement and all producers of amusements are required to collect tax from the patrons and remit the collected 
         Amusement Tax                    taxes to the City of Pittsburgh. If the entity is a charitable non profit performing arts, please provide a current copy of the Federal 
                                          990 tax return, Non profit   Charter, and PA sales and use tax certificate of exemption with the completed registration.
                  Parking Tax             All persons or entities within the City  ofPittsburgh who park or store motor vehicles for a consideration are required to register 
                                          and collect the Parking Tax from patrons.
                                          Entities engaged in service in the medical, education, social, recreational, vocational or any other type of services where there is 
                  Institution &           a charge collected, except elementary and secondary schools, are required to pay gross receipts. Exception is receipts from the 
        Service Privilege                 sale of food, drink, or merchandise.
                  Tax
                                          Every employer who employs one or more non-resident employee who earn scompensation as aresult of services performed a              t 
                  Non-Resident            a publically funded facility within the city, to engage in an athletic event or otherwise render performance for which a non-
         Sports Facility                  resident receives remuneration is required to withhold and remit the fee to the Treasurer as result of services performed at a 
                  Usage Fee               publicly funded facility within the city.
        1.Type of Taxes
          Check ALL of the business taxes you expect or are required to pay and/or collect:
                  Payroll Expense Tax                                  Local Service  Tax s                               Non-Resident Sports Facility Usage Fee 
                  Parking Tax                                          Amusement Tax                                      Institution & Service Privilege Tax (Non-Profit Entities Only )

                  Employer Withheld Wage Tax: Please Contact Jordan Tax Service - (412) 345-7968 (www.jordantax.com/Act32/Employer.html) to register for a 
                                                                          withholding account for the Earned Income Tax.
For more information on City taxes, please visit our Finance website at:                                                http://pittsburghpa.gov/finance/tax-descriptions 

    For question          scontact: Call Tax Payer Services at (412)255-8822                            or Email       : taxcompliance@pittsburghpa.gov
Section 5: Additional Parking Tax Information                                                     *ONLY complete this section if you are liable for Parking tax
        1. Operator's Name (last name, first name)                                                                 2. BBI Permit Number
         
        3. Property Owner's Name (last name, first name)                                    4. Property Owner's Telephone Number

5. Property Owner's Address                                                                 City                                       State                Zip Code

6. Parking Lot/ Garage Location*                                                                       7. Former Operator's Name

Address should be identical to the one appeared on your Parking Permit and Application with the Bureau of Building Inspection
        8. Check ALL that apply to your parking location below:
                  Surface Lot                                                    Automatic Ticket-Spitter                                  Computerized Reporting System

                  Garage                                                         Manually Issued Tickets                                   Leased Spaces Only 

        9.Max Vehicle.    Capacity                                     10.Number of Free Spaces                                        1 .1How often does   the rate change?

Rev  . 11/19

                                                                       Continue to Section 5 on Page 3                                                               Page 2 of 3



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                                      City of Pittsburgh 
                                      Department of Finance                                                      Business Registration Form
                                      414 Grant Street Room 207 
                                      Pittsburgh, PA 15219                                                       Complete this form to create a business account with the City of 
                                                                                                                 Pittsburgh. The City will assign your business a 9 digit account number. 
                                      Assistance? Call:  412 255-2543(     )                                     This form will not be processed or considered complete until this form is 
                                      Email: registration@pittsburghpa.gov                                       signed and dated. 
                                                                                                                                                                        CITY ID #:
                                      Fax:  412 255-6821(      ) 
                                                                                                                                                               PARKING ID #:
                                                                                                                                                    *ONLY complete this section if you are
Continued Section 5: Additional Parking Tax Information                                                                                                        liable for Parking Tax

                TAXPAYER IS REQUIRED TO NOTIFY CITY OF PITTSBURGH WHEN RATES CHANGE 

1 .2Please List Weekly Hourly Rates

                1-1  _____________                                                         3-  _______________4                                                         6- _______ _______7 _

                2-  _____________  2                                                       4- _______________ 5                                                         7- _______________8 

                                                                                           5-  _______________6                                                                           8+ _______________
                3-  _____________  3
1 .3Please List Fixed Rates

       Fixed/Flat Rate  _______________                                                                                            Night Rate  _______________ 

       Early Bird Rate  _______________                                                                                            Event Rate  _______________

1 .4Please List Weekend Rates                                                                                 1 .5Please List Current Night Rates
       Saturday ______________                                                                                Monthly _____________                             Daily ______________ 

       Sunday  ______________                                                                                 Hourly ______________   
1 .6Please List Lease Rates                                                                                   1 .7Other  *Please specify below

       Lease Rates _____________

        Monthly                         _____ _______          _

Section  : Signature6                                (REQUIRED)
I, the undersigned, do hereby affirm that this official government document has been examined by me and to the 
best of my knowledge and belief, is true, correct and complete.
1. Signature of Owner / Officer                                                                              2. Print Full Name                                3. Date Signed

4. Phone Number                                                                                              5. Title

                                                                     Submission of Business Registration Form

                After completing and signing this business registration form, please submit your registration to:
                                                                           1. Email  :  registration@pittsburghpa.gov
                                                                           2. Mail to :   Registration, City of Pittsburgh
                                                                                          414 Grant Street Room 207 
                                                                                          Pittsburgh, PA 15219-2476
 For Office Use ONLY:              Select Application Type:                                                                        
Rev  . 11/19
                                                                                                                                                                                             Page 3 of 3






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