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    Illinois Department of Revenue

    REG-1 Illinois Business Registration Application

Register faster using MyTax Illinois, our online account management program, available at mytax.illinois.gov  . If you have questions, visit our 
website at tax.illinois.gov or call us weekdays between 8:00 a.m. and 4:30 p.m. at 217 785-3707.
Step 1:  Identify your business or organization                              6   Check the organization type that applies to you:
  1 Federal employer identification number (FEIN)                                q         Proprietorship
    FEIN:  ______ - __________________                                                     ____ Check if owned by a married couple or civil union
   Proprietorships must provide the Social Security number (SSN)                 q         Partnership            q              Trust or estate
    under which taxes will be filed.                                             q         Corporation*           q              S Corp (Subchapter S Corporation)*
  SSN:   _________ - ______ - ____________                                                 * Is your corporation publicly traded?  ___ Yes            ___ No
  2 Legal business name:                                                                   If yes, provide the ticker symbol ____________
                                                                                 q         Governmental unit      q              Not-for-profit organization
  ___________________________________________________ 
                                                                                 q         LLC - Corporation       q             LLC - Partnership
  3 Doing-business-as (DBA), assumed, or trade name,  if different 
    from Line 2:                                                                 q         LLC - S Corporation    q              LLC - Single member
                                                                                 ____ Check if your organization type is disregarded
    ___________________________________________________ 
  4 Primary or legal business address:                                         7 Illinois Secretary of State identification number:
                                                                                ___ - ___ ___ ___ ___ - ___ ___ ___ - ___
  ___________________________________________________
    Street address - No PO Box number              Apartment or suite number
                                                                               8 Is your business part of a unitary group?  ___ Yes     ___ No
  ___________________________________________________                            If “Yes”, provide the FEIN of your designated agent (the entity
           City                                    State       ZIP      
                                                                                 responsible for filing your Illinois income tax return):
    If you have other locations in Illinois from where you do 
    business, complete and attach Schedule REG-1-L.                              FEIN:  ______ - __________________
  5 Mailing address if different from the address above:                       9 Identify a contact person regarding your business.
  ___________________________________________________                           Name:  __________________________ Title: _____________
    In-care-of name
                                                                                 Phone:  (______) ______ - ________   Ext.: __________
  ___________________________________________________
    Street address or PO Box number                Apartment or suite number     FAX:    (______) ______ - ________
  ___________________________________________________                            Email address:                 ______________________________________
    City                                           State   ZIP

Step 2:  Identify your owners and officers - If you need to identify more, attach Schedule REG-1-O.
10  Identification depends on the organization type you selected in Step 1, Line 6 (proprietorship - owner(s); partnership - general partners; non-publicly traded
    corporation - president, secretary, and treasurer; publicly traded corporation - chief operating officer and chief financial officer; trust or estate - trustee(s) or 
    executor(s); governmental unit - one contact person; not-for-profit organization - president, secretary, or treasurer; limited liability company - managers and  
    members). For each individual or business required, complete the following information.
Individuals: (include Social Security number (SSN))
  a      ___________________________________       _________________            d          ___________________________________         _________________
         Name                                      Title                                   Name                                        Title
     ______________________________________________________                                 ______________________________________________________  
         Home address - No PO Box number City            State ZIP                         Home address - No PO Box number       City             State     ZIP
         ____ / ____ / ________          (______) ______ - ________                        ____ / ____ / ________                (______) ______ - ________ 
         Date of birth                   Phone                                             Date of birth                         Phone 
         _______ - _____ - _________  Ownership percentage: ______                         _______ - _____ - _________  Ownership percentage: ______ 
         Social Security number                                                            Social Security number
  b      ___________________________________       _________________          Businesses:(include federal employer identification number (FEIN))
         Name                                      Title                        a          ___________________________________ ____-_____________
     ______________________________________________________                                Name                                        FEIN
         Home address - No PO Box number City            State ZIP                         ______________________________________________________  
                                                                                           Legal  address
         ____ / ____ / ________          (______) ______ - ________                        ______________________________________________________  
         Date of birth                   Phone                                             City                                                 State       ZIP 
         _______ - _____ - _________  Ownership percentage: ______                         (______) ______ - ________            Ownership percentage: ______
         Social Security number                                                            Phone  
  c      ___________________________________       _________________            b          ___________________________________ ____-_____________
         Name                                      Title                                   Name                                        FEIN
     ______________________________________________________                                ______________________________________________________  
         Home address - No PO Box number City            State ZIP                         Legal  address
         ____ / ____ / ________          (______) ______ - ________                        ______________________________________________________  
         Date of birth                   Phone                                             City                                                 State       ZIP 
         _______ - _____ - _________  Ownership percentage: ______                         (______) ______ - ________            Ownership percentage: ______
         Social Security number                                                            Phone  
REG-1 (R-01/22)                                                                                                                  *74501221W*

  Step 3:  Tell us about your business activities                             Services
11 Describe your business activities: ______________________                  Do you transfer items, on which tax must be collected, as part of your 
     ____________________________________________                             service?   ____ Yes    ____ No
    Provide your North American Industry Classification System                When will (did) this activity begin?  ____/____/_____
   (NAICS) number: ___________________________________                        Purchaser (Self-assessed Use Tax)
     Refer to the website www.naics.com                                       Does your supplier collect Illinois Sales Tax for merchandise your 
12   Will you have Illinois employees?    ____ Yes    ____ No                 business uses or consumes in Illinois?                                                                 ____ Yes    ____ No
     If yes, complete and attachSchedule REG-UI-1.                            Does your supplier collect Illinois Sales Tax on sales of aviation fuel 
     When was (is) the date of your first payroll in Illinois?                your business uses or consumes in Illinois?  ____ Yes    ____ No
      ____/____/_____                                                         When will (did) these activities begin?  ____/____/_____
13 Check all that apply to your type of business.                             Cigarettes and other tobacco products
  Sales and Use Tax                                                           q Cigarettes - See Schedule REG-1-C before you check here.
When will (did) these activities begin?  ____/____/_____                      q Tobacco products - See Schedule REG-1-C before you check here.
   You must complete and attach Schedule REG-1-L to identify all Illinois     q Cigarette machine operator - See Schedule REG-1-C before you
locations from which you must collect the local sales tax rate.               check here.
q    General merchandise:  ____ Retail    ____ Wholesale                      When will (did) these activities begin?  ____/____/_____
Note: Refer to the Leveling the Playing Field Resource Page for               Renting or leasing
guidance on registering for Retailers’ Occupation Tax.                        q Hotel rooms for less than 30 days - Attach Schedule REG-1-L.
Do you estimate your monthly sales and use tax liability will be over         Do you charge for telecommunication services?____ Yes    ____ No
$200?    ____ Yes    ____ No                                                         Vehicles for one year or less - Attach Schedule REG-1-L.
                                                                              q
q    Sales to Illinois customers from out of state                                   Vehicles for more than one year
                                                                              q
   ____ Check if you have an Illinois presence, including, but                When will (did) these activities begin?  ____/____/_____
   not limited to having an office or other facility in Illinois or having    Utility Service Providers
   employees or other representatives operating in Illinois.                         Electricity:  ____ Retail    ____ Wholesale
                                                                              q
   ____  Check if you have inventory in Illinois or if your Illinois                 Natural gas:  ____ Retail    ____ Wholesale
                                                                              q
   presence is due to inventory within the state. Attach Schedule REG-1-L.           Telecommunications - See Schedule REG-1-T.
                                                                              q
   ____ Check if you make $100,000 or more in annual sales from                       ____ Retail    ____ Wholesale
   your own sales to Illinois purchasers.                                            Water or sewer services
                                                                              q
   ____ Check if you make 200 or more separate transactions                   Do you choose to voluntarily collect the Water and Sewer Assistance
   annually from your own sales to Illinois purchasers.                       Charge for:       ____ Water        ____ Sewer
Are you registering as an out of state remote retailer?                       Are you a utility cooperative?    ____ Yes    ____ No
____ Yes    ____ No                                                           Are you a municipality?    ____ Yes    ____ No
When will (did) these activities begin?  ____/____/_____                      When will (did) these activities begin?  ____/____/_____
q Check if you are a marketplace facilitator-Attach Schedule REG-1-MKP.
                                                                              All other tax types
q Soft drinks (other than fountain soft drinks) in Chicago                           Liquor warehousing - Attach Schedule REG-1-A.
                                                                              q
q Vehicle, watercraft, aircraft, or trailers                                         Dry cleaning:  ____ Facility    ____ Solvent supplier
                                                                              q
q Sales or delivery of tires. Do you always pay the Tire User Fee to                 Own/operate coin-operated amusement devices
                                                                              q
your supplier?    ____ Yes    ____ No                                                You wish to purchase electricity for non-residential use and pay
                                                                              q
q Sales from vending machines. How many vending  machines? ____               the tax to IDOR - Attach Schedule REG-1-D.
q Liquor at retail (bar, tavern, liquor store, etc.)                                 You wish to purchase natural gas from outside of Illinois for your
                                                                              q
q Motor fuel/fuel:  ____ Retail    ____ Wholesale - Attach Form REG-8-A       own use and pay the tax to IDOR - Attach Schedule REG-1-G.
   ____ Check here if you are required to collect prepaid sales tax.
q Sales of Motor Fuel in a county that imposes County Motor Fuel Tax          q Not listed. Identify: _________________________________
q Sales of Motor Fuel in a municipality that imposes Municipal Motor Fuel Tax When will (did) these activities begin?  ____/____/_____
q    Aviation fuel:  ____ Retail    ____ Wholesale
   (if wholesale, attach Form REG-8-A)
q Medical cannabis - Attach Schedule REG-1-MC.
____ Cultivation Center    ____ Dispensing Organization
When will (did) these activities begin?  ____/____/_____

Step 4:  Sign below - Under penalties of perjury, I state that I have examined this information and, to the best of my knowledge, it is true,
correct, and complete. I further attest that I will be responsible for filing returns and paying all taxes due unless Schedule REG-1-R, Responsible 
Party Information, is attached to this application or forwarded to the department. Check here if you are attaching or forwarding Schedule REG-1-R: q 
Signature:     _______________________________________                        Title:  ________________________                                                                       Date:  ___/___/______  
Printed name:   _______________________________________                       SSN:    ______ - _____ - _________
Address:     _______________________________________                          Phone:  (______) ______ -_________ 

   Mail your completed form, with any required                       CENTRAL REGISTRATION DIVISION 
   attachments and payment to:                                         ILLINOIS DEPARTMENT OF REVENUE
                                                                       PO BOX 19030  
                                                                       SPRINGFIELD IL 62794-9030
   This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this information is required. Failure to provide *74501222W*
   information may result in this form not being processed and may result in a penalty. Printed by the authority of the state of Illinois REG-1 (R-01/22) - Web only - One copy
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