Temporary registration certificate If you are conducting temporary business and need a Temporary Registration Certificate, complete and submit the form below. We will respond to your e-mail request within two business days. You will receive: a confirmation message with your Unified Business Identifier (UBI)/Tax Registration Number via e-mail. your Temporary Registration Certificate by mail at the address provided below. Complete the form and click "Submit". * Indicates required field UBI/Tax Registration Number (if previously issued) (Example: 123456789) Name of Business (if applicable) Name of Business Owner * E-mail Address of Person completing this form * Business Telephone Number * Type of Business * (Example: sole owner, association, partnership, corporation, limited liability company) Mailing Address * Street City * City State * State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip * Zip First Date of Event * (Example: MM/DD/YYYY, 01/14/2002) Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Last Date of Event * (Example: MM/DD/YYYY, 01/14/2002) Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Name of Event * Location of Event * Type of Goods Sold/Services Provided * Reset
