Multi-Page Form Demo

Demographics

Business Entity Information

Only fields marked with red asterisks are required.

Legal form

Is the business entity organized for profit or non-profit?

Nonprofit Profit

Has your business received a determination from the Internal Revenue Services (IRS) that this corporation is exempt from federal income tax? *

No Yes

ID type *

ID *

Pennsylvania Department of State Entity ID

Notice of Required Registration letter ID

Name

Legal name of entity

Doing business as (DBA) name

Establishment location name (if it is different than the DBA name)

Entity Physical location

Country

Street 1 *

Street 2

Unit type

Unit number

City *

State

ZIP *

County *

Do you have additional PA locations other than listed above? *

No Yes

Additional Entity Addresses

Is your business address also your mailing address? *

No Yes

Is your business address also where your records are located? *

No Yes

Business Entity Registration

Only fields marked with red asterisks are required.

Did this entity acquire all or part of another business entity?

No Yes

Did this entity result from a change in legal structure (for example, from individual proprietor to corporation, partnership to corporation, corporation limited liability company)?

No Yes

Did this entity undergo a merger, consolidation, dissolution or other restructuring?

No Yes

Date of first operations

Date of first operations in PA

Business entity fiscal year end

Phone country

Phone type

Business entity telephone number

Phone extension

Entity Business Activity Information

Choose North American Industry Classification System (NAICS) code for your primary business activity

NAICS Instructions

To add NAICS codes, Click on "Add a Record" link.
Enter a NAICS code, if you already know it or search for NAICS codes using "Search NAICS Code" button.
Enter a word that describes your business in the Keyword field, or enter 2-6 digits of your NAICS code.
Select the code from the results list.
Enter the percentage for each NAICS code.
Specify if this NAICS code is primary or not.

NAICS verified

Please select one NAICS Code as Primary.

NAICS Code	NAICS Code description	Percentage	This is my primary activity

Description of business activity

Enter the percentage that this establishment's receipts or revenues represent of the total PA receipts or revenues of the Business Entity

Establishments engaged in construction must enter the percentage of construction activity that is new and/or renovative.

New construction

+

Renovative construction

=

Sum of new and renovative construction

Residential construction

+

Commercial construction

=

Sum of residential and commercial construction

Accounts

Registration Questions

Is the business entity registering for a Sales, Use and Hotel Occupancy License or Transient Vendor Certificate?

No Yes

Has the business entity ever been a lottery retailer in the past?

No Yes

Does the business entity want to become a Pennsylvania Lottery Retailer?

No Yes

Does or will the business entity have employees, non-employees, and/or need to report income withholding?

No Yes

Is the business entity registering for a Tobacco License?

No Yes

Is the business entity actively promoting shows in Pennsylvania where taxable products will be offered for retail sale?

No Yes

Is the business entity engaged solely in the sale of tangible personal property and/or services for resale or rental?

No Yes

Is the business entity purchasing taxable products or services for its own use in Pennsylvania and incurring no sales tax?

No Yes

Employer Accounts Registration

Employer Withholding Tax (W-2)

Other Income Withholding Tax (1099-NEC and 1099-MISC)

Retirement Withholding Tax (1099-R)

Unemployment Compensation

Workers' Compensation Coverage

Entity Establishment Employer Information

Does the establishment employ individuals who work in Pennsylvania?

No Yes

Does the establishment employ PA residents who work outside of Pennsylvania?

No Yes

Does the establishment pay remuneration for services to a person(s) you do not consider an employee(s)?

No Yes

Does the establishment report non-resident withholding on non-employees compensation, business or lease payments?

No Yes

Does the establishment have Form 1099-R reporting for taxable distribution from a benefit trust, deferred payment or retirement plan for PA residents?

No Yes

Employment Information

Date wages first paid

Date wages resumed when following a break in employment

Total number of employees

Number of employees primarily working in new construction

Number of employees primarily working in renovative construction

Estimated gross wages per quarter

Agency Details

Does the establishment have Workers' Compensation insurance?

No Yes

If this establishment does not have Workers' Compensation insurance, Please select one of the options:

Employer Summary

Please review the information below and go to the previous step to make any changes.

Below are the Employer accounts that are requested.

Employer Withholding Tax

Other Income Withholding Tax

Retirement Withholding Tax

Unemployment Compensation

Workers' Compensation Coverage

Owner, Officer, Partner, Shareholder, Responsible Party Information

⚠ Single member LLC's must have only one owner/officer.

Type	ID	Business/Individual name	Percentage of ownership

Multi-Page Form Demo

Demographics

Business Entity Information

Name

Entity Physical location

Additional Entity Addresses

Business Entity Registration

Entity Business Activity Information

Choose North American Industry Classification System (NAICS) code for your primary business activity

Accounts

Registration Questions

Employer Accounts Registration

Entity Establishment Employer Information

Employment Information

Agency Details

Employer Summary

Owner, Officer, Partner, Shareholder, Responsible Party Information

Owner, Officer, Partner, Shareholder, Responsible Party Information

Contact

Tax Responsibility

Name

Address

Owner Consent

Address Verification

Add NAICS Code

Add Address