City of Toledo 
                                                     Division of Taxation  
                          One Government Center, Ste 2070, Toledo, OH 43604, Office (419) 245-1662, Fax (419) 936-2320 
                                                      Email:  incometax@toledo.oh.gov 
                                                                                         
                          ACCT# __________________________       Date:                    ____________________________ 
                                                                                          
                                                     Business Registration Form 
                                                                                          
                              FAILURE TO FULLY COMPLETE MAY RESULT IN DELAYS IN PROCESSING 
Business/Account Type:  
       (R)                              (B)                                       (C)                       (B)                    (X)                (W) 
  Schedule C or E            Form 1065             Form 1120/1120S                       Form 1041          Form 990          Withholding      
(Single Member LLC / Sole Proprietorship) (Partnership) (Single Member LLC / Corporation)   (Association / Trust)  (Non-Profit Entity)   (Voluntary Withholder) 
 
______________________________________________________                                 _______________________________________________________ 
FEDERAL TAX ID # (If Applicable)                                                       Toledo Business Name 
 
______________________________________________________                                 _______________________________________________________   
Business Name                                                                          Toledo Address (if different) 
 
______________________________________________________                                 _______________________________________________________ 
Business Address                                                                       Toledo Address City, State, Zip 
 
______________________________________________________                                 Provide the name and FEIN under which the withholding tax will  
Business City, State, Zip                                                              be remitted (if different) 
 
______________________________________________________                                 _______________________________________________________ 
Business Phone #                                                                       Name (if different)                                          FEIN (if different) 
 
______________________________________________________                                 _______________________________________________________ 
Business Fax #                                                                         Email Address 
 
1. Starting date of Toledo activities _________________________________________ 
 
2. Are there now or will there be employees subject to Toledo income tax?  Yes______ No______  Remote Only _______ 
             
    Will you be filing monthly (withholding > $200/month)? Yes ______ No ______   Payroll starting date _______________ 
 
3. Accounting period: Calendar Year? ___________ or Fiscal Year Ending ________________________________ 
 
4. Nature of business _________________________________________________________________________________ 
 
5. Do you now or will you conduct business within Toledo city limits?   Yes_________   No_____________ 
 
Corporate Officers/Non Profit Board Members:           
Name                                                Residential Address                                              Social Security # (Required):  
 
President: ________________________________________________________________________________ 
 
Treasurer: ________________________________________________________________________________ 
 
Partners: (attach additional sheets if necessary):  
Name                                                Residential Address                                              Social Security # (Required): 
 
_________________________________________________________________________________________ 
 
_________________________________________________________________________________________ 
 
_________________________________________________________________________________________ 
  
Sole Proprietor: (including Single Member LLC): 
Name                                                Residential Address                                              Social Security # (Required): 
 
_________________________________________________________________________________________ 
 
Signature ___________________________________________                                     Title_____________________________________ 
 
Printed Name ________________________________________                                     Date ____________________________________ 

                              FAILURE TO FULLY COMPLETE MAY RESULT IN DELAYS IN PROCESSING