CITY AND COUNTY OF SAN FRANCISCO – OFFICE OF THE TREASURER & TAX COLLECTOR JOSÉ CISNE ROS, TREASURER GEORGE PUTRIS, TAX ADMINISTRATOR Taxpayer Assistance, City Hall – Room 140 #1 Dr. Carlton B. Goodlett Place, San Francisco, CA 94102 TEL.: (415) 554-4400; FAX: (415) 554-6207 www.sftreasurer.org I N S T R U C T I O N S BUSINESS REG ISTRATION CERTIFICATE APPLICATION: PARTNERSHIPS, CORPORATIONS and LIMITED LIABILITY ENTITIES COMPLETING THE APPLICATION: Pleas e type or print legibly. B USINESS STRUCTURE: Check the box that describes the ownership of your business. If the ownership is somet hing other than a partnership, corporation or limited liability entity, check “Other” and indicate the nature of the ownership. OWNERS HIP NAME: For a general partnership, list the names of all partners here. If more than 30 characters, you may use initials for first names, and/or “et al”; the full names of all partners, however, must be listed on the second page/ side of the application. For a corporation, LLC, LLP, or LP, provide the entity name as registered with the Secret ary of State. FED ERAL EMPLOYER IDENTIFICATION NUMB ER (FEIN, a.k.a. EIN): An FEIN is required for all part nerships, corporations, and LLCs (ot her than single-member LLCs, which may use either an FE IN or Social Security Number). This number is obtained from the Internal Revenue Service. Proof of FEIN issued by the IRS may be required to be submitted with the application. STATE CORPORATE NUMB ER: For corporations who have filed Articles of Incorporation or Limited Liability Companies (LLCs) or Limited Liability Partnerships (LLPs) who have filed Articles of Organization with the Sec retary of State. B USINESS START DATE IN S.F.: The date the entity started business activity in San Francisco or the date of registration if business activity has not commenced. Per the San Francisco Business and Tax Regulations Code (A rticle 12, Section 856[ f]), an entity “shall have 15 days after commencing business within the City to apply for a registration certificate”. ADDRESS ES: The business mailing address is the address to which this office can mail all documents. Any valid mailing address (including home or postal box) is acceptable. If the address of the location where accounting records are kept is the same as the mailing address, check the box; otherwise provide address. If the physical location of the business is the same as the mailing address, check the box; otherwise provide address. Please not e that a postal box is not accept able to list as a business location. For additional San Francisco locations, use an additional form or supply an attached sheet. RES IDENTIAL AND COMMERCIAL LESSORS (only if applicable): Residential landlords renting units in a building of four or more units, or in multiple buildings in San Francisco, are required to register as a business with the Tax Collector. All commercial landlords renting units in San Francisco are required to register with the Tax Collector. Indicate the total number of residential and/or commercial units. B USINESS NAME (DB A – “DOING B US INESS AS” or FB N “ FICTITIOUS B US INESS NAME”): The name(s) your business is using to conduct business in San Francisco. Note: Whereas your business name may be as long as you like, only 30 characters will appear on the Business Registration Certificate issued by the Office of the Treasurer & Tax Collector. For additional FBNs and locations, use an additional form or supply an attached sheet with complete information. It is advisable to check the County Clerk’s online database of registered FBNs in San Francisco to ensure that you are comfortable with the name or names you are using for your business. After registering with the Tax Collector, all businesses with location in San Francisco and using an FBN must register the name with the County Clerk (City Hall, Room 168; 415-554-4950). B USINESS DESCRIPTION: Provide a brief description of the primary nature of the business (i.e., source of revenue or activity – e.g., “Clothing – retail”, “Furniture – Wholesale”, “Consulting Services”, “Mortgage Brok er”, “Full Service Restaurant”, etc.). If there is more than one type of business activity or revenue source, use more than one line. ES TIMATED SAN FRANCISCO ANNUAL TAXAB LE PAYROLL and NUMB ER OF EMPLOY EES: The amount of estimated payroll expense and the estimated number of employees expected to be employed during the first full year of operation in San Francisco. IMPORTANT: Complete, sign, and date the second page/side of the application and remit the required registration fee. Refer to “Understanding the SF Business Registration Certificate” ( www.sfgov.org/tax/businessforms ) for fee information. Information must be filled out completely in order to ensure timely processing. Starting wit h renewals for the 2011-2012 fiscal year, the registration certificate must be renewed annually on or before May 31 for the upcoming fiscal year (beginning July 1). Revised 04/12/11 American LegalNet, Inc. www.FormsWorkFlow.com CITY AND COUNTY OF SAN FRANCISCO – OFFICE OF THE TREASURER & TAX COLLECTOR JOSÉ CISNEROS, TREASURER GEORGE PUTRIS, TAX ADMINISTRATOR (FOR OFFICE USE ONLY) Business Tax & Taxpayer Assistance, City Hall – Room 140 #1 Dr. Carlton B. Goodlett Place, San Francisco, CA 94102 TEL.: (415) 554-4400; FAX: (415) 554-6207 www.sftreasurer.org Certificate No.: Registration Fee(s) Paid: Staff Initials and Date: A P P L I C A T I O N BUSINESS REGISTRATION CERTIFICATE PARTNERSHIPS, CORPORATIONS and LIMITED LIABILITY ENTITIES Please type or print legib ly. General B USINESS STRUCTURE: Partnership Limited Partnership (LP) Corporation Limited Liability Entity (LLC, LLP) OTHER: □ □ □ □ □ (Che ck one box) (Describe ownership type) OWNERS HIP NAME: Partners’ Names (Last, First) or Corporate Name or Organization Name (Will be entered as 30 characters or less) Federal Employer Identification Number (FEIN) S tate Corporate/Organization Number (if applicable) S tart Date in S .F. (required) B USINESS MAILING ADDRESS: Last Name First Name Middle Initial ( Street Address (Postal boxes are acceptable for mailing address) City ) Area Code State Title/Position (optional, if nee ded) Telephone ZIP Code Country (for foreign addresses only) ----------------------------------------------------------------------------------------------------------------------------------------------ACCOUNTING RECORD LOCATION: □ Check here if same as Business Mailing Address; otherwise enter address below. Last Name First Name Middle Initial Title/Position ( ) Area Code Street Address City State Telephone ZIP Code Country (for foreign addresses only) ----------------------------------------------------------------------------------------------------------------------------------------------B USINESS LOCATION (PO B ox not acceptable): □ Check here if same as Business Mailing Address; otherwise enter address below Street No. Street Name Suite/Room RESIDENTIAL AND COMMERCIAL LESSORS ONLY: City Total # of Residential Units: State ZIP Code Total # of Commercial Units: B USINESS NAME (DB A): (Note: Only 30 characters will appear on your Business Registration Certificate) FOR OFFICE USE ONLY B USINESS DESCRIPTION: Description of Primary Business Activity Est. Payroll (12 mos.) Est. # of Employees Business Class PBC Description of Primary Business Activity Est. Payroll (12 mos.) Est. # of Employees Business Class PBC  APPLICATION CONTINUES ON THE REVERSE SIDE  Revised 04/12/11 American LegalNet, Inc. www.FormsWorkFlow.com OWNERSHIP DETAIL: List all general and/or limited partners, officers, members, or other entities that make up the ownership of the business. If there are more than three owne rship entities, please attach an additional s heet (or sheets) as needed. Last Name First Name Middle Initial Residence Address City, S tate ZIP Code ( S ocial Security Number ) Area Code Telephone ................................................................................................................................................................................................................................................ IF GEN ERAL PARTN ERS HIP, LLC, LLP, OR JOINT VENTURE: IF CORPORATION: IF LP: □ □ □ □ Corporate Officer Percentage of Ownership = □ Major S tockholder Both General Partner Limited Partner % Percentage of Ownership = % Last Name First Name Middle Initial Residence Address City, S tate ZIP Code ( S ocial Security Number ) Area Code Telephone ................................................................................................................................................................................................................................................ IF GEN ERAL PARTN ERS HIP, LLC, LLP, OR JOINT VENTURE: IF CORPORATION: IF LP: □ □ □ □ Corporate Officer Percentage of Ownership = □ Major S tockholder Both General Partner Limited Partner % Percentage of Ownership = % Last Name First Name Middle Initial Residence Address City, S tate ZIP Code ( S ocial Security Number ) Area Code Telephone ................................................................................................................................................................................................................................................ IF GEN ERAL PARTN ERS HIP, LLC, LLP, OR JOINT VENTURE: IF CORPORATION: IF LP: □ □ □ □ Corporate Officer Percentage of Ownership = □ Major S tockholder Both General Partner Limited Partner % Percentage of Ownership = % I declare under penalty of perjury, under the laws of the State of California, that I have examined this application and that the information contained herein is true and complete to the best of my knowledge and belief. I understand that misrepresentation of information is subject to a penalty of up to $500. (San Francisco Business and Tax Regulations Code, Section 6.17-3). AUTHORIZED REGISTRANT: Signature DATE: Print Full Name (and title, if necessary to clarify authorization) TELEPHONE: ( ) Area Code Telephone Revised 04/12/11 American LegalNet, Inc. www.FormsWorkFlow.com