Request For License Renewal - City Of Prattville printable pdf download

Request For License Renewal - City Of Prattville

CITY OF PRATTVILLE

REQUEST FOR LICENSE RENEWAL

No.

IN ACCORDANCE WITH SECTION 2002-10 CODE OF ORDINANCES

LICENSE YEAR

EXPIRING

APPLICATION IS HEREBY MADE FOR RENEWAL OF AN OCCUPATIONAL LICENSE TO OPERATE A BUSINESS, PROFESSION, OR OCCUPATION IN

ACCORDANCE WITH THE CODE OF ORDINANCES OF THE CITY OF PRATTVILLE, AND ANY APPLICABLE STATE AND FEDERAL STATUTES.

I FURTHER CERTIFY UNDER PENALTY OF PERJURY AND CANCELLATION OF LICENSE THAT THERE HAS BEEN NO CHANGES

AFFECTING INFORMATION FURNISHED ON MY INITIAL APPLICATION FOR LICENSE OR ANY REVOCATION (IF APPLICABLE) OF

ANY LICENSE(S) ISSUED BY THE DEPARTMENT OF PROFESSIONAL REGULATIONS.

LICENSE FOR

LOCATION OF BUSINESS

PENALTY

PRIOR TO JAN 31

PENALTY

15%

PRIOR TO MARCH 2

30%

PENALTY

AFTER MARCH 2

INTEREST IS 1% OF TOTAL AMOUNT DUE

PER MONTH PAST DUE

City of Prattville

P.O. Box 680190.

Prattville, AL 36067-3033

Phone (334) 361-3690 or (334) 361-3612 Fax (334) 361-3608

BASED

SCHEDULE

CODE

I CERTIFY THAT THE ABOVE INFORMATION IS CORRECT.

Total License: $_____________

Interest: $_____________

CONTACT NAME ______________________________________________

Penalty: $_____________

Issuance Fee: $_____________

10.00

NAME ________________________ TITLE ________________________

Total Remitted: $_____________

SUBSCRIBED AND SWORN BY ME THIS ______ DAY OF ________ _____

If you are no longer engaged in business in Prattville, please notify this office to avoid further notice.

Request For License Renewal - City Of Prattville