Business License Application Form - City Of Auburn, Oh
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1BUSINESS LICENSE APPLICATION
1. APPLICANT’S NAME _____________________________________________________ Date of Birth ___________________
2. SOC. SEC. NO. ______--_____--_________ DRIVER LICENSE NO. __________________________ STATE _____________
3. TRADE NAME OR “D.B.A.” OF BUSINESS __________________________________________________________________
4. LEGAL NAME IF DIFFERENT FROM D.B.A. _________________________________________________________________
5. STREET ADDRESS/CITY, STATE & ZIP OF BUSINESS _______________________________________________________
6. IF STREET ADDRESS IS IN AUBURN: OWNER’S NAME ___________________________ADDRESS AND PHONE
NUMBER ________________________________________________________________________________________
7. MAILING ADDRESS (if different from street address) __________________________________________________________
8. TELEPHONE NO. (_____) _____-______; FAX NO (_____) ____-______ E-MAIL ADDR ________________________
9. BUSINESS TYPE: ___(1)Manufacturer ___(2)Contractor ___(3)Wholesaler ___(4)Retailer ___(5)Other
10. ORGANIZATION TYPE: ___(1)Corporation ___(2)Partnership ___(3)Proprietorship ___(4)Prof. Assoc. ___(5) Other
11. DESCRIPTION OF BUSINESS ACTIVITIES IN AUBURN _______________________________________________________
12. IF YOU ARE A CONTRACTOR, THE CONTRACT MATERIAL WILL BE DELIVERED TO THE AUBURN JOB SITE BY:
___ Supplier(s) from whom it is purchased.
___ I, the contractor, who will withdraw it from my inventory.
13. DO YOU HAVE SALESPERSONS WHO PERSONALLY SOLICIT BUSINESS IN AUBURN? ___YES ___NO
14. HOW ARE YOUR GOODS DELIVERED TO AUBURN? ___ Company-owned or leased vehicles ___ Common carriers
15. HOW MANY BUSINESS LICENSE DECALS ARE NEEDED FOR VEHICLES OPERATING IN AUBURN?____________
16. WHAT IS YOUR FIRST DAY OF BUSINESS IN AUBURN? _______ / _______ / _______
(Month)
(Day)
(Year)
17. HOW MANY PERSONS (NOT INCLUDING OWNER OR PARTNERS) WILL BE EMPLOYED IN AUBURN BY THE
BUSINESS APPLYING FOR THIS LICENSE? __________
18. BUSINESS IDENTIFICATION NUMBERS (Write “NONE” if no number has been assigned)
Federal Employer I. D. No. ___________________ Alabama Sales/Use Tax No. ____________________
19. OWNERS, PARTNERS, OR OFFICERS (List additional persons on reverse side)
Name
Home Address
Social Security Number
Title
_________________________ ____________________________ ______________________________ ____________________
_________________________ ____________________________ ______________________________ ____________________
If business has pool tables, coin-operated laundry machines, vending, or amusement machines, please list business address
where machines are located, number, and type of machine on the back of this form.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS RETURN AND TO THE BEST OF MY
KNOWLEDGE AND BELIEF, IT IS TRUE, CORRECT, AND COMPLETE. MY SIGNATURE INDICATES THAT I TAKE FULL
RESPONSIBILITY FOR THIS RETURN AND ANY TAX LIABILITY THAT MIGHT OCCUR.
_______________________________________
______________________________________________
Print Name of Owner/Partner/Officer
Signature of Owner/Partner/Officer
_______________________________________
______________________________________________
Title
Date
PLEASE RETURN THE COMPLETED FORM TO THE ABOVE ADDRESS BEFORE THE FIRST DAY OF BUSINESS
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Parent category: Legal