Business License Application Form - Alabama Revenue Department
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1
2Revenue Department
City of Opelika
204 South Seventh Street
Opelika, Alabama 36801
(334) 705-5160 or (334)705-5162
Fax: (334) 705-5163
BUSINESS LICENSE APPLICATION
PART I.
BUSINESS INFORMATION
Type of Application: ☐ Renewal
☐ Individual
Business Organization:
☐ New License
☐ Partnership
Check one
Check one
☐ Corporation
☐ Regular License
☐ LLC
Type of License:
☐ Occupational License
☐ Non-Profit
Check one
☐ Name Change
☐ Owner Change
License Change:
(Check one if applicable)
DBA/Trade Name: _________________________________________________________FEIN: __________________________________
Physical Location: Street Address: ____________________________________________Business Phone #: _________________________
City, State Zip: ____________________________________________Secondary Phone #: ________________________
Mailing Address: (if different from physical location)
Street Address: ____________________________________________City, State Zip: ____________________________
(Complete description of any and all business activities and any activity which comprises 10% or more of the total gross receipts)
Type of Business: (any activity which comprises 10% or more of the total gross receipts.)
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
☐ Yes
☐ No
Do you have employees working in the city limits of Opelika?
PART II.
OWNER INFORMATION
Owner’s Name:
_______________________________________________Social Security #:_______________________
Driver License#/State Issued: ________________________________________ Date of Birth: _________________________
State Certification #: _______________________________________________State Card: ____________________________
Electrical and Plumbing contractors must have a $5,000 surety bond.
PART III.
CONTACT INFORMATION
Contact Name: __________________________________________________ Phone #:________________________________
Email Address: __________________________________________________ Fax #: _________________________________
PART IV.
LICENSE CALCULATION
License Fee:
____________________
__________________________________________________
Signature of Owner or Legal Representative
Additional Fee: ____________________
Issuance Fee:
____________________
__________________________________________________
Date
Penalty:
____________________
This application has been examined by me and is, to the best of my
knowledge, a true and complete representation of the above named
Total Due:
____________________
entity, and person(s) listed.
All Requirements Must Be Verified and a License Requirement Verification Completed (where required) Before Issuance of License.
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