Mobile Vendor License Application Form - City Of Westport

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MOBILE VENDOR LICENSE APPLICATION
CITY OF WESTPORT
P.O. BOX 505
WESTPORT, WA 98595
PHONE: (360) 268-0131
FAX: (360) 268-0921
BUSINESS NAME _________________________________________________________________________________
TYPE OF BUSINESS ______________________________________________________________________________
OWNERS NAME _________________________________________________ PHONE _________________________
OWNERS DRIVERS LICENSE NUMBER ______________________________________________________________
OWNERS ADDRESS (MAILING) _____________________________________________________________________
VENDOR LOCATION (PHYSICIAL) ___________________________________________________________________
(Written permission by the property owner is required prior to issuing license.)
PROPERTY OWNER _______________________________________________________________________________
FEDERAL ID NUMBER ___________________________
STATE UBI NUMBER___________________________
STATE LICENSE NUMBER ___________________________________________
VENDORS ONLY (INCLUDING SEAFOOD VENDORS): LOCATION ________________________________________
ANNUAL VENDING LICENSE FEE - $300.00 THE FIRST YEAR, $250.00 FOR ANNUAL RENEWAL.
I hereby understand that purchasing a business license to operate a business inside the city limits of Westport
is on a yearly basis and obligates me to pay quarterly Excise Tax (Business & Occupation). Rates are as follows:
a)
Service and all other Retailing: .005 of gross income for the quarter.
b)
Wholesale Manufacturing: .0025 of gross income for the quarter.
c)
Wholesale Distributor: No quarterly excise tax reports are required.
d)
Quarterly statements must be signed and returned regardless of income earned for each
quarter. Please review your excise tax statement penalty section for additional information.
I also verify that the information concerning my business is factual and I also understand that if I change
business type in any way at the same location, I will notify the City at once. Let it be known, that if you have
falsely represented your business in any way, or are operating in a zone restricting your business type, your
license will be promptly revoked.
Applicant Signature: _________________________________________________ Date: ________________________
Code Enforcement Official use only:
Zoning Requirements ____________________________________________ Approved ________ Denied ________
(Reason If Denied)_________________________________________________________________________________
_________________________________________________________________________________________________
Code Enforcement Official (Signature)________________________________________________________________
c:pat/admin/vendor/lic-appl

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