License Renewal Application Form
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1LICENSE RENEWAL APPLICATION
YOUR LICENSE IS BASED ON A FEE AND YOUR GROSS ANNUAL BUSINESS FOR THE
PREVIOUS YEAR.
COMPLETE THE FOLLOWING FORM USING THE ATTACHED SCHEDULE(S).
INCLUDE PERTINENT INFORMATION FOR EACH SCHEDULE ON WHICH APPLICATION IS MADE.
SEND THE COMPLETED FORM ALONG WITH YOUR CHECK TO:
REVENUE DIVISION
P. O. BOX 569
NORTHPORT, AL 35476
GROSS RECEIPTS
SCHEDULE
RETAIL
WHOLESALE
OTHER
LICENSE AMOUNT
========
======
=========
=====
==============
ISSUANCE FEE
$0.00
$0.00
$0.00
$0.00
TOTALS
I HEREBY ENCLOSE MY CHECK IN THE AMOUNT OF
FOR MY CITY LICENSE BASED ON
GROSS ANNUAL BUSINESS OF
FOR THE YEAR JUST ENDED.
I HEREBY CERTIFY THAT
THE ABOVE AMOUNT OF GROSS ANNUAL BUSINESS IS CORRECT SUBJECT TO THE PENALTIES PROVIDED FOR IN
THE LICENSE SCHEDULE.
DATE
NAME OF COMPANY
OWNER OR AUTHORIZED SIGNATURE
ADDRESS
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Parent category: Financial