If you're like many small business owners, you may be wondering what Form B 104 is and whether or not you need to file it. This form is used to report the amount of money a business pays in New Jersey state taxes. Generally, businesses with income of more than $50,000 per year must file this form. However, there are some exceptions, so it's best to speak with an accountant or tax specialist to determine if you need to file Form B 104. Failing to submit this form can result in hefty fines, so it's important to take care of this requirement if applicable.
Question | Answer |
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Form Name | Form B 104 |
Form Length | 4 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 1 min |
Other names | FD, DVM, Ghanian, washington state birth certificate form |
BIRTH RECORD
FATHER’S INFORMATION |
Page 1 of 2 |
Mother’s Name:
Mother’s Date of Birth:
Medical Record Number:
Father’s Information: Please Print Clearly
What is your current legal name?
First Name |
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Middle Name |
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Last Name |
Suffix |
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What is your mailing address (if different from the mother)? |
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Same as the mother's address |
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Number and Street address, P.O. Box or Rural Route numbers |
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Apartment Number |
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City or Town |
State |
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Zip Code |
If not United States, please enter country. |
What is your date of birth?
MMDD YYYY
Where were you born?
City or Town |
State or Foreign Country |
What is your social security number?
I don’t have a Social Security number.
Form # B 104 |
01/01/2010 |
BIRTH RECORD
FATHER’S INFORMATION |
Page 2 of 2 |
What is your highest level of education?
Mother’s Name:
Mother’s Date of Birth:
Medical Record Number:
Check the box that best describes your highest level of school completed at the time of your child’s birth.
8th grade or less
9th – 12th grade, no diploma
High school graduate or GED completed Some college credit but no degree Associate degree (AA, AS)
Bachelor’s degree (BA, AB, BS)
Master’s degree (MA, MS, MEng, Med, MSW, MBA)
Doctorate degree ( PhD, EdD, MD, DDS, DVM, LLB, JD)
ARE YOU SPANISH/HISPANIC/LATINO? If you are not Spanish/Hispanic/Latina, check the "NO" box. If you are, check the box that is most appropriate for you.
No, not Spanish/Hispanic/Latino
Yes, Spanish/Hispanic/Latino
Mexican, Mexican American, Chicano
Puerto Rican
Cuban
Other Spanish/Hispanic/Latino PLEASE SPECIFY:
FATHER’S RACE: Check all that apply to indicate what you consider yourself.
Caucasian (white) |
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Asian |
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Black or African American |
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Asian Indian |
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Somali |
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Chinese |
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Ethiopian |
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Filipino |
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Liberian |
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Japanese |
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Ghanian |
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Korean |
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Kenyan |
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Vietnamese |
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Sudanese |
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Hmong |
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Nigerian |
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Cambodian |
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Other African |
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Laotian |
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PLEASE SPECIFY: |
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Other Asian |
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PLEASE SPECIFY: |
American Indian or Alaska Native |
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Other Race |
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Name of Enrolled or Principal Tribe |
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PLEASE SPECIFY: |
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PLEASE SPECIFY: |
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Pacific Islander
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
PLEASE SPECIFY:
Form # B 104 |
01/01/2010 |
FETAL DEATH REPORT
FATHER’S INFORMATION |
Page 1 of 2 |
Father’s Information: Please Print Clearly
What is your current legal name?
Mother’s Name:
Mother’s Date of Birth:
Medical Record Number:
First Name |
Middle Name |
Last Name |
Suffix |
What is your mailing address (if different from the mother)?
Number and Street address, P.O. Box or Rural Route numbers |
Apartment Number |
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City or Town |
State |
Zip Code |
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If not United States, please enter country. |
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What is your date of birth?
MMDD YYYY
Where were you born?
City or Town
What is your social security number?
State or Foreign Country
I don’t have a Social Security number.
Form # FD 104 |
01/01/2010 |
FETAL DEATH REPORT
FATHER’S INFORMATION |
Page 2 of 2 |
What is your highest level of education?
Mother’s Name:
Mother’s Date of Birth:
Medical Record Number:
Check the box that best describes your highest level of school completed at the time of your child’s birth.
8th grade or less
9th – 12th grade, no diploma
High school graduate or GED completed Some college credit but no degree Associate degree (AA, AS)
Bachelor’s degree (BA, AB, BS)
Master’s degree (MA, MS, MEng, Med, MSW, MBA)
Doctorate degree ( PhD, EdD, MD, DDS, DVM, LLB, JD)
ARE YOU SPANISH/HISPANIC/LATINO? If you are not Spanish/Hispanic/Latina, check the "NO" box. If you are, check the box that is most appropriate for you.
No, not Spanish/Hispanic/Latino
Yes, Spanish/Hispanic/Latino
Mexican, Mexican American, Chicano
Puerto Rican
Cuban
Other Spanish/Hispanic/Latino PLEASE SPECIFY:
FATHER’S RACE: Check all that apply to indicate what you consider yourself.
Caucasian (white) |
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|
Asian |
|||
Black or African American |
|
|
Asian Indian |
|||
Somali |
|
|
Chinese |
|||
Ethiopian |
|
|
Filipino |
|||
Liberian |
|
|
Japanese |
|||
Ghanian |
|
|
Korean |
|||
Kenyan |
|
|
Vietnamese |
|||
|
|
|
|
|
|
|
Sudanese |
|
|
Hmong |
|||
|
|
|
|
|
|
|
Nigerian |
|
|
Cambodian |
|||
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|
|
|
|
|
|
Other African |
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|
Laotian |
|||
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|
|
|
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|
PLEASE SPECIFY: |
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|
Other Asian |
|||
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PLEASE SPECIFY: |
American Indian or Alaska Native |
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|
Other Race |
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Name of Enrolled or Principal Tribe |
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PLEASE SPECIFY: |
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PLEASE SPECIFY: |
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Pacific Islander
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
PLEASE SPECIFY:
Form # FD 104 |
01/01/2010 |