North Carolina Nonresident Business Notification

Nonresident Business Notification
Form NC-NBN
Web-Fill
10-19

NC-NBN

Nonresident Business Notification

4

✖

PRINT

CLEAR

DOR Use Only

Legal Name

Disaster
Response
Period

Trade Name

Beginning

Ending

(MM-DD-YY)

(MM-DD-YY)

Date Disaster-Related Work Concluded in NC

Mailing Address

City

State

Zip Code

(MM-DD-YY)

Date of Entry into NC

FEIN or SSN

(MM-DD-YY)

Name of Contact Person

Phone Number

Date of Disaster Declaration

Date of Exit from NC

(MM-DD-YY)

(MM-DD-YY)

Fax Number

Important: If a nonresident business fails to submit a timely Nonresident Business Notification, the nonresident business will forfeit the relief provided to the nonresident business
which exempts the business from certain North Carolina business registration and tax laws. For additional details, see North Carolina General Statute 166A-19.70A and Session Law
2019-187 (SB 498).

Nonresident Employee Information (If additional lines are needed, attach Schedule NEI available from the Department’s website.)
Name
(Last, First, and Middle Initial)

Social Security
Number

Principal Address
(Street Address, City, State, and Zip-Code)

Date of Entry
into NC
(MM-DD-YY)

Date of Exit
from NC
(MM-DD-YY)

Amount of Compensation Paid for Work
Performed in NC by Calendar Year
Compensation
Calendar Year
(YYYY)
Amount

A nonresident business must provide notification to the Department of Revenue within 90 days of the date the nonresident business concludes its disaster-related work in North Carolina.
Mail this notification to: North Carolina Department of Revenue, Attn: Business Liaison - Examination Division, PO Box 871, Raleigh, North Carolina 27602-0871.