Schedule Car-100-M - Annual Report - New Jersey Department Of Revenue
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1ANNUAL REPORT
SCHEDULE
Include with your CBT Return
CAR-100-M
(See Reverse Side For Instructions)
A.
BUSINESS IDENTIFICATION
BUSINESS NAME
FEIN
FILING YEAR
BUSINESS ID
B.
BUSINESS ADDRESSES
MAIN BUSINESS ADDRESS INFORMATION (REQUIRED)
NAME
STREET
CITY
STATE
ZIP CODE
PRINCIPAL BUSINESS ADDRESS INFORMATION
NAME
STREET
CITY
STATE
ZIP CODE
C.
OFFICERS/DIRECTORS (Required)
NAME
TITLE
STREET
CITY
STATE
ZIP CODE
NAME
TITLE
STREET
CITY
STATE
ZIP CODE
NAME
TITLE
STREET
CITY
STATE
ZIP CODE
Check box if you have more than three officers/directors. Attach a schedule.
D.
CHANGE OF REGISTERED AGENT/OFFICE (Use only if you are making a change)
NAME
STREET
STATE
ZIP CODE
CITY
E.
FEE AMOUNT
ENTER YOUR ANNUAL REPORT FEE OF $50 (OR $75 WITH REGISTERED AGENT/OFFICE CHANGE) ON LINE 20, PAGE 1 OF CBT-100 or CBT-100S.
Signature
Date:
(Chairman of the Board, President, Vice-President, Registered Agent, General Partner or Authorized Representative)
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