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Business Registration (New Jersey)

This form is registration for a business and public records filing for new business in New Jersey. The form provided here is simply a sample of what the actual Form NJ-REG looks like.

Business Registration

A. Please indicate the reason for your filing this application. (Check only one box)

____ Original application for a new business
____ Application for a new location of an existing business.
____ Amended application for an existing business.
____ Moved previously registered business to new location (NJ-C can be used in lieu of NJ-REG)

Give name and NJ Registration Number of existing business

____________________________

B. FEIN # ____________________________

OR

Social Security # of Owner ____________________________

C. Name ____________________________ (If incorporated give Corporation Name; If not, give Last Name, First Name, MI of Owner, Partners)

D. Trade Name ____________________________

E. Business Location: (Do not use P.O. Box for location address)

Street ____________________________

City ____________________________

State ____________________________

Zip Code ____________________________ (Give 9-digit Zip)

F. Mailing Name and Address: (If different from business address)

Name ____________________________

Street ____________________________

City ____________________________

State ____________________________

Zip Code ____________________________ (Give 9-digit Zip)

G. Beginning date for this business in New Jersey

____________________________ (see instructions)

H. Type of ownership (check one):

____ NJ Corporation
____ Limited Partnership
____ Sole Proprietor
____ S Corporation
____ Partnership
____ Limited Liability (1065 Filer)
____ Out-of-State Corporation
____ Limited Liability (1120 Filer)
____ Other ____________________________

I. New Jersey Business Code ____________________________ (see instructions)

J. County/Municipality Code ____________________________ (see instructions)

K. County ____________________________

L. Will this business be open all year? ____ Yes ____ No

If NO - Circle months business will be open:

JAN FEB MAR

APR MAY JUN

JUL AUG SEP

OCT NOV DEC

M. IF A CORPORATION, complete the following:

Date of Incorporation: ____________________________

State of Incorporation: ____________________________

Fiscal Month: ____________________________

Is this a Subsidiary of another corporation? ____ Yes ____ No

If YES, give name and Federal ID # of parent ___________________

N. Standard Industrial Code ____________________________ (if known)

O. Provide the following information for the owner, partners or responsible corporate offices. (If more space is needed, attach rider.)

NAME

Last Name ____________________________

First Name ____________________________

Middle Initial ____________________________

Social Security Number ____________________________

Title ____________________________

HOME ADDRESS

Street ____________________________

City ____________________________

State ____________________________

Zip ____________________________


NAME

Last Name ____________________________

First Name ____________________________

Middle Initial ____________________________

Social Security Number ____________________________

Title ____________________________

HOME ADDRESS

Street ____________________________

City ____________________________

State ____________________________

Zip ____________________________


NAME

Last Name ____________________________

First Name ____________________________

Middle Initial ____________________________

Social Security Number ____________________________

Title ____________________________

HOME ADDRESS

Street ____________________________

City ____________________________

State ____________________________

Zip ____________________________

Each Question Must Be Answered Completely

1.a. Will you be paying wages, salaries or commissions to employees working in New Jersey? ____ Yes ____ No

Give date of first wage or salary payment:

b. Give date of hiring first NJ employee:

c. Will you be paying wages, salaries or commissions to New Jersey residents working outside New Jersey? ____ Yes ____ No

d. Will you be the payer of pension or annuity income to New Jersey residents? ____ Yes ____ No

e. Will you be holding legalized games of chance in New Jersey (as defined in Chapter 47 Rules of Legalized Games or Chance) where proceeds from any one prize exceed $1,000?

____ Yes ____ No

f. Date cumulative gross payroll exceeds $1,000

2. Did you acquire

___ Substantially all the assets; ____ Yes ____ No

___ Trade or business; ____ Yes ____ No

___ Employees; of any previous employee units? ____ Yes ____ No

If answer is "No", go to question 4.
If answer is "Yes", indicate by a check whether ___ in whole or ___ in part, and list business name, address and registration number of predecessor or acquired unit and the date business was acquired by you. (If more than one, list separately. Continue on separate sheet if necessary.)

Name of Acquired Unit ____________________________

N.J. Employer ID ____________________________

Address ____________________________

____________________________

Date Acquired ____________________________

ACQUIRED

___ Assets Percentage Acquired

___ Trade or Business Percentage Acquired

___ Employees Percentage Acquired

3. Subject to certain regulations, the law provides for the transfer of the predecessor's employment experience to a successor where the whole of a business is acquired from a subject predecessor employer, unless the acquired protests within four months from date of acquisition.

The transfer of the employment experience is required by law if the predecessor and successor units are owned or controlled by each other or by the same interests. Are the predecessor and successor units owned or controlled by the same interests?

____ Yes ____ No

Do you protest the transfer of the employment experience which may affect your contribution rate? ____ Yes ____ No

4. Is your employment agricultural? ____ Yes ____ No

5. Is your employment household? ____ Yes ____ No

a. If yes, please indicate calendar quarter in which gross cash wages totaled $1,000 or more

6. Are you a 501(c)(3) organization? ____ Yes ____ No

7. Were you subject to the Federal Unemployment Tax Act (FUTA) in the current or preceding calendar year? ____ Yes ____ No

(See instruction sheet for explanation of FUTA) If "Yes", indicate year

8.a. Does this employing unit claim exemption from liability for contributions under the Unemployment Compensation Law of New Jersey? ____ Yes ____ No

If "Yes," please state reason. (Use additional sheets if necessary.)

b. If exemption from the mandatory provisions of the Unemployment Compensation Law of New Jersey is claimed, does this employing unit wish to voluntarily elect to become subject to its provisions for a period of not less than two complete calendar years? ____ Yes ____ No

9. Type of business

___ 1. Manufacturer

___ 2. Service

___ 3. Wholesale

___ 4. Construction

___ 5. Retail

___ 6. Government

Principal product or service

Type of Activity

10. List below each place of business and each class of industry in New Jersey, even though you may have only one place of business or engage in only one class of industry.

a. Do you have more than one employing facility in New Jersey?

____ Yes ____ No

NJ Work Locations (Physical location, not mailing address)

Street Address ____________________________

City ____________________________

Zip Code

County ____________________________

Nature of Business (see instructions) ____________________________

Business Code ____________________________

Principal Product or Service ____________________________

____________________________%

No. of Workers at Each Location and/in Each Class of Industry

11.a. Will you collect New Jersey Sales Tax and/or pay Use Tax? ____ Yes ____ No

GIVE EXACT DATE YOU EXPECT TO MAKE FIRST SALE

b. Will you need to make exempt purchases for your inventory or to produce your product? ____ Yes ____ No

c. Is your business located in (check applicable box(es)):

___ Atlantic City
___ North Wildwood
___ Salem County
___ Wildwood Crest
___ Wildwood

d. Do you have more than one location in New Jersey that collects New Jersey Sales Tax? (If yes, see instructions)

____ Yes ____ No

e. Do you, in the regular course of business, sell, store, deliver or transport natural gas or electricity to users or customers in this state whether by mains, lines or pipes located within this State or by any other means of delivery? ____ Yes ____ No

12. Do you intend to sell cigarettes? ____ Yes ____ No
Note: If yes, complete the REG-L form in this booklet and return with your completed NJ-REG. To obtain a cigarette retail or vending machine license, complete the CM-100 in this booklet.


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