NEW ACCOUNT REGISTRATION FORM 
                                                                                                                    Email: support@revds.com 
                                                                                                                       Phone (800) 556-7274 
                                                  Required Fields are in BOLD.                                             Fax (205) 423-4099 

1. Legal Business Name : ____________________________________FEIN/Social Security #: ________________________
2. Business Type:    Sole Proprietorship    General Partnership            Corporation            LLC – Single Member   LLC – Multi Member 
    LLP          Governmental Agency        Professional Association       Other (please explain) _________________________ 
3. Mailing Address:
________________________________________________________________________ _________________________________ ___________ ______________ ____________________________ 
          (Mailing Address)                                                                                                  (City)                                                       (State)                 (Zip)                              (County) 
4. Phone Number :(______)________________________________ Fax: __(______)_____________________________________
5. Name(s) of Owner(s):
  ____________________________________________________________ _________________________________________ _________________________ _______ ________ ________________ 
                  (Last, First, Middle)                                                                   (Residence Address)                          (City)                                          (State)       (Zip)                (SSN) 
_____________________________________________________________ _________________________________________ _________________________ _______ ________ ________________ 
                  (Last, First, Middle)                                                                   (Residence Address)                          (City)                                          (State)       (Zip)                (SSN) 
_____________________________________________________________ _________________________________________ _________________________ _______ ________ ________________ 
                  (Last, First, Middle)                                                                   (Residence Address)                          (City)                                          (State)       (Zip)                (SSN) 
_____________________________________________________________ _________________________________________ _________________________ _______ ________ ________________ 
                  (Last, First, Middle)                                                                   (Residence Address)                          (City)                                          (State)       (Zip)                (SSN) 
_____________________________________________________________ _________________________________________ _________________________ _______ ________ ________________ 
                  (Last, First, Middle)                                                                   (Residence Address)                          (City)                                          (State)       (Zip)                 (SSN) 
6. Contact Person: _________________________________________________Title: ____________________________________
   Email: _________________________________________________________ Phone:___________________________________
7. Physical Locations:
_______________________________________________ ____________________________________________ ___________________________ ________ _________ _______________________ 
           Doing Business As (DBA)                         (Physical Address)                                                             (City)                                            (State)          (Zip)                             (County) 
_______________________________________________ ____________________________________________ ___________________________ ________ _________ _______________________ 
          (DBA)                                                        (Physical Address)                                                              (City)                                            (State)          (Zip)                            (County) 
_______________________________________________ ____________________________________________ ___________________________ ________ _________ _______________________ 
          (DBA)                                                        (Physical Address)                                                              (City)                                            (State)          (Zip)                            (County) 
_______________________________________________ ____________________________________________ ___________________________ ________ _________ _______________________ 
          (DBA)                                                        (Physical Address)                                                              (City)                                            (State)          (Zip)                            (County) 
_______________________________________________ ____________________________________________ ___________________________ ________ _________ _______________________ 
          (DBA)                                                        (Physical Address)                                                              (City)                                            (State)          (Zip)                            (County) 
8. Begin Date _________________Description of Business__________________________________________________________
9. NAIC Code___________________________ (See page 2 for a comprehensive listing of NAIC codes or visit http://www.naics.com.)
10. Indicate the Jurisdiction(s) you will be filing tax in:
(Please see tax rate listing for a current list of all Jurisdictions administered by RDS at www.revds.com.) 

___________________________________________________________________________________________________________ 

___________________________________________________________________________________________________________ 

___________________________________________________________________________________________________________ 
11. Liabilities. Indicate the Type and Rate you will be Filing/Purchasing:
   Type:        Sales Tax      Seller’s Use Tax    Consumer Use Tax        Business License/Certificate             Permit  DID/BID 
           Other, please specify _____________________________________________ 
   Rate:         General Rate Automotive Rate     Mfg. Machine Rate       Agricultural Rate            Amusement Rate      Vending 
Note: Your municipality may require the purchase of a Business License in order to conduct business in addition to filing other tax types. Online filing for 
business licenses for municipalities administered by RDS is available at www.bizlicenseonline.com. See www.revds.com for more information. 
12. Sworn Statement:
   I declare, under penalties of perjury, that this return (and any accompanying schedules) has been examined by me and to
   the best of my knowledge is true, correct and complete.
   Print Name:  ______________________________ Signed:  ____________________________ Date Signed: _________

   Title:  ______________________________ Phone #: _______________________ Email: _________________________

Account Registration - RDS Updated 07/2015 

            File Your Taxes Online! Purchase your Business License/Certificates/Permits Online! 
                                  Free Voluntary Online Filing and Payment Now Available 
                                     Visit www.revds.com for    Additional Information 
 Questions?  Contact RDS Support via email at                   support@revds.com          or toll-free at (800) 556-7274 
                                        Commonly Used NAIC Codes -- http://www.naics.com 
Description                                                     NAIC      Description                                                              NAIC 
Air Conditioning Repair                                         238220   Gasoline Station (a convenience store too; but primarily sells gas,   447110 
                                                                         e.g. has Exxon, Shell or Chevron, etc. in the name) See convenience 
                                                                         store that sells gasoline. 
Automobiles New Car Dealers                                     441110   Gasoline Station (not a convenience store; just gas)                  447190 
Automobiles Used Car Dealers                                    441120   General Store (if groceries are sold too)                             445110 
Automotive / Auto Parts (new)                                   441310   Hardware Store                                                        444130 
Automotive / Body Shops                                         811121   Hospital Equipment and Supplies                                       423450 
Automotive / Car Wash                                           811192   Hotels & Motels                                                       721110 
Automotive / Junkyards, Auto Parts (used)                       441310   HVAC (Heating Ventilation Air Conditioning) Repair                    238220 
Automotive / Repair Shops                                       811111   Ice Cream Dairy Products Stores                                       445299 
Automotive / Tire Dealers                                       425110   Interior Design Service                                               541410 
Bakery                                                          311811   Jewelry Store                                                         448310 
Beauty Salons                                                   812112   Junkyards Auto Parts (used)                                           441310 
Beer "Package" Stores Liquor,  Wine                             445310   Lawnmower Repair (small engine)                                       811411 
Bicycle Shop (Service & Sales)                                  451110   Liquor "Package" Stores Beer Wine                                     445310 
Body Shops (automotive)                                         811121   Livestock Care (not pets)                                             541940 
Book Stores                                                     451211   Manufactured Home Dealer                                              453930 
Building Materials / Electrical                                 423610   Medical Eq and Supplies                                               423450 
Building Materials / Heating and Air Conditioning               423730   Mobile Home Dealer                                                    453930 
(HVAC) 
Building Materials / Lumber (home center, sells tools,          444110   Nurseries, Garden Centers, and Farm Supply Stores                     444220 
lightbulbs, household goods, too) 
Building Materials / Lumber (not a home center)                 444190   Office Furniture Manufacturing                                        337214 
Building Materials / Plumbing                                   423720   Package Stores Liquor, Beer Wine                                      445310 
Building Materials / Ready Mix Concrete                         327320   Paint & Wallpaper Stores                                              444120 
Building Materials / Sand & Gravel                              423390   Parcels & Postal (UPS Stores, etc)                                    491110 
Building Materials / Stone, Brick                               444190   Pet Care (not vets, e.g. grooming and supplies)                       812910 
Building Materials Stores - Retail                              444190   Pet Care (Vets)                                                       541940 
Car Washing                                                     811192   Pet Stores & Supplies                                                 453910 
Child Care (Day Care)                                           624410   Pharmacies                                                            446110 
Clothing / Children's and Infants’ Wear Stores                  448130     Ready Mix Concrete                                                  327320 
Clothing / Family                                               448140   Roofing Materials Dealers                                             423330 
Clothing / Men's (incl Men's and Boy's)                         448110   RV Recreational Vehicle Dealer                                        441210 
Clothing / Other (e.g. work clothes, uniforms, accessories)     448190   Security Systems Services                                             561621 
Clothing / Women's                                              448120   Shoe Stores                                                           448210 
Computer Sales & Service                                        811212   Snack Machine Operators                                               454210 
Dairy Products Stores, Ice Cream                                445299   Sporting Goods Store                                                  451110 
Dental Eq and Supplies                                          423450   Stained Glass Dealers                                                 327215 
Dental Lab                                                      339116   Sunglasses Stores                                                     453998 
Drug Stores                                                     446110   Supplies / Building Materials Stores - Retail                         444190 
Fabric Stores                                                   451130   Supplies / Electrical                                                 423610 
Farm Supply Stores                                              444220   Supplies / Heating and Air Conditioning (HVAC)                        423730 
Fireworks                                                       453998   Supplies / Lumber         (home center, sells tools, lightbulbs,      444110 
                                                                         household goods, too) 
Flea Markets (incl. booths)                                     453310   Supplies / Lumber (not a home center)                                 444190 
Flooring Contractor                                             238330   Supplies / Plumbing                                                   423720 
Florists                                                        453110   Supplies / Stone, Brick                                               444190 
Food / Convenience Store (no gasoline sales)                    445120   Tanning Salons                                                        812199 
Food / Convenience Store (selling gasoline too, but store name  447110   Tire Dealers                                                          425110 
usu. Quick Mart, Tom Thumb, etc) 
Food / Grocery Store                                            445110   Tobacco Shops and Stores                                              453991 
Food / Restaurants - Fast Food                                  722211   Used Merchandise - Retail                                             453310 
Food / Restaurants - Full Service Restaurant                    722110   Variety Stores                                                        452990 
Frame Shops                                                     339999   Vending Machine Operators                                             454210 
Fruit & Vegetable Mkt                                           445230   Wholesale Trade Agents & Brokers                                      425120 
Furniture Store                                                 442110   Wine "Package" Stores Liquor, Beer                                    445310 
Garden Centers                                                  444220