CITY OF PORT HURON
PH-2 (Revised 12/17)
                                                  INCOME TAX REGISTRATION
1.  Federal Employer Identification Number (FEIN)                                      2. Type of Business Ownership (check one only)

3.  Complete company name (include if applicable, Corp., Inc., P.C., etc.)                  Individual owner
                                                                                          Owner's full name
4.  Mailing address (this is the address where forms and correspondence will be mailed)
                                                                                          Owner's social security number

5.  Withholding address (if you want withholding forms sent to a different address)         Partnership                 Subchapter S Corp.

                                                                                            Corporation                 Limited Liability Co.

                                                                                            Other - explain:

List all locations of your business in the City of Port Huron                 (attach a separate sheet if necessary)
If you have no business location in the city, state "None"
6A.  Business name in Port Huron (DBA)                                                                              Approximate number of employees

Address in Port Huron (number and street)

6B.  Business name in Port Huron (DBA)                                                                              Approximate number of employees

Address in Port Huron (number and street)

6C. Business name in Port Huron (DBA)                                                                               Approximate number of employees

Address in Port Huron (number and street)

7.  Briefly describe your business activity

                                                                                    If no, give month of closing
8.  Do you close your tax books on December 31?      No   Yes

                                                          If yes, previous owners name                              Previous owners FEIN (if known)
9.  Was this business previously
     operated by another employer?       No       Yes

                                                          Name                                                      Telephone number & area code
If we have questions about this form who should we call?

Type or print the name of owner or officer responsible for filing tax returns          Title

Signature                                                                              Date

Return to: Income Tax Division, 100 McMorran Boulevard, Port Huron, MI   48060                                      Questions? call (810) 984-9741