City of Northport, Alabama
Business License Application
Note: The City of Northport Imposes its Business License Tax Within its Police Jurisdiction.
(CONFIDENTIAL)
3500 McFarland Boulevard
Phone (205)339-7000
P.O. Box 569
Fax (205)333-3005
Northport, AL 35476
Please Print or Type
See Reverse Side for Instructions and Further Information
Application Date: ______________
Proposed Start Date: ________________
Application Type:
New
Owner Change
Name Change
Location Change
Reactivation
Legal Business Name ___________________________________________________________________
___________________________________
Trade Name (DBA) if different from above
_______________________________
Brief description of business activity in Northport
(Example: retail clothing sales, wholesale food sales, rental of industrial equipment, computer consulting)
Form of Ownership
Sole Proprietorship
Partnership
Corporation
LLC
Other (Specify)____________________ (If LLC,
LLP or Corp. please attach signed Affidavit )
___________________________________________________
Physical Address
-
(Street)
(City)
(State)
(Zip)
___________________________________________________
Mailing Address
(Street)
(City)
(State)
(Zip)
______________
_____________
____________
(Business)Telephone
Fax
(E-Mail)
FEIN __________________________ ST of Ala Tax # __________________________
List the Owner(s), Partners or Officers (Attach separate sheet if necessary) Include copies of Drivers Licenses.
Name
Residence Address
SSN
DL ST. # & Exp. date
Home Phone
DOB
1.___________________________________________________________________
2.___________________________________________________________________
3.___________________________________________________________________
TITLES (Owner, Pres etc.) 1. _____________________2.___________________________3.____________________
__________________________________
Name and phone number for contact person
____________________
If business has physical location in Northport, list name of manager
# of Employees __________
Land/Building:
Own
Rent
___________________________________________________
If Rent: Owner:
__________________________________________
__________
Address
Phone