Business License Application Form - Montgomery County
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1MONTGOMERY COUNTY BUSINESS LICENSE APPLICATION
101 S. Lawrence Street, Montgomery, AL 36104
(334) 832-1248
Mailing Address:
____________________________________________________________________________________________________________
1. Business Name:
____________________________________________________________________________________________________________
City:
____________________________________________ State: ________________________________ Zip:____________________
Physical Address:
____________________________________________________________________________________________________________
Is business inside the city limits? (Please check one)
Yes
No
(Please check one)
Yes
No
2. Business Phone:
_________________________________________
3. Is this a home based business?
4. Briefly describe business: _______________________________________________________________________________________________________________
6. Business Type: (Please check one)
5. Date Business Opened in Montgomery County: ___________________________
Sole Proprietor
Social Security No. _______________________________
Partnership
Federal I.D. No.
_______________________________
Corporation
7. Business or Owner’s Email Address: ________________________________________
8. Owner’s Name
Title
Address
Telephone #
____________________________________
_______________ ____________________________________________________________
__________________________
____________________________________
_______________ ____________________________________________________________
__________________________
____________________________________
_______________ ____________________________________________________________
__________________________
____________________________________
_______________ ____________________________________________________________
__________________________
Do you have a license to sell in another county in Alabama? (Please check one)
Yes
No
SALES – Retail or Wholesale
9.
Fixed Location (Permanent) or Transient ____________________
Bicycles
Tobacco
Electronics
Computers
Magazines
Playing Cards
(check all items you sell)
Cell Phones
Appliances
Auto Accessories
Soft Drinks
Do you have a valid Section 84 (contractor’s license) in another county in Alabama? (Please check one)
Yes
No
10. CONTRACTOR SERVICES (Paint, construction, roofing, etc.)
(Note: If you have answered “Yes”, please contact us at 334-832-1248 before proceeding.)
(Fiscal period – October 1 – September 30)
Provide an estimate of gross receipts in the State of Alabama for fiscal tax year:
$_________________________
(SUBJECT TO AUDIT)
Food Service, Auto Dealer, Auctioneer or Second County Transient
11. Additional Permits Required for:
Bond #:
___________________________
Regulatory License#:
___________________________
Health Permit#:
___________________________
First County:
___________________________
12. I declare under penalty of perjury that the above information is true and correct.
________________________________________________________________
___________________________
Signature of owner or authorized agent
Date
OFFICE USE ONLY
________________
Clerk
Section
Fee
Section
Fee
___________________________________
_____________
_________________________________ ______________
__________________
___________________________________
_____________
_________________________________ ______________
License#
___________________________________
_____________
_________________________________ ______________
__________________
ID#
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Parent category: Business