Form Center

2. 
3. BUSINESS REGISTRATION APPLICATION

   Submit/Print here

   Contact Information
   The Township of Pine
   Attn: Business Tax Office
   230 Pearce Mill Road
   Wexford, PA 15090
   724-625-1636 x117

5. Business Information
7. Business Name (d/b/a)*
8. Federal EIN (if applicable)
10. Pine Business Address*
12. Business Start Date*
    Business Start Date
13. Business Activity*
15. Furnish the name and contact information of the person/department that will be responsible for completing the tax return
17. Business Contact*
18. Phone Number*
20. Email Address*
21. Business Website
23. Legal/Corporate Name (if different from Business Name)
25. Business Contact Address (if different from Pine Business Address)
27. Type of Entity (Check One)*

    1. Sole Proprietor/Single Member LLC
    2. Partnership
    3. Corporation
    4. Non-Profit (attach IRS determination letter)
28. If Non-Profit and an Institution of Purely Public Charity, please attach a copy of the IRS Determination Letter
30. Would you like your website included in the Business listing on the Township website?

    1. Yes (enter website address)
    2. No
31. Enter the website address
33. Electronic Signature Agreement*

    The applicant certifies that the above information is complete and accurate and correct to the best of the applicant's knowledge and belief.

    The applicant agrees to comply with the provisions of the Township of Pine's Ordinances, Codes and Regulations, and all other applicable laws and regulations of Allegheny County, the Commonwealth of Pennsylvania, and the United States, whether or not specified in this application.

    1. I Agree
35. Electronic Signature*
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field