Business Operations Tax Application Form - City Of Sacramento

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CITY OF SACRAMENTO
REVENUE DIVISION
N
0
BUSINESS OPERATIONS TAX APPLICATION
BUSINESS NAME
STARTING DATE
BUSINESS DESCRIPTION
BUSINESS ADDRESS
Mo
Day
Yr
Street No
Street Name
(916)
City
State
ZIP Code
Phone Number
Business Zoned:
Commercial or
~esidential Home Occupation Permit #
(Check one)
COMPLETE THIS SECTION IF MAILING INFORMATION IS DIFFERENT THAN ABOVE
MAILING NAME
ATTENTION
ADDRESS
Street N o .
Street Name
City
State
Zip Code
PRIMARY OWNER1
CORPORATI ON
(916)
Last
First
MI
Home
/
Business Ph.
No
.
HOME /CORPORATE
ADDRESS
Street No.
Street Name
CHECK ONE:
OWNER NAME #2
city
State
-
SOLE PROPRIETOR
Zip Code
SHAREHOLDER
-
PARTNERSHIP
Last
First
MI
OWNER NAME #3
SHAREHOLDER
-
CORPORATION
Last
First
MI
FEDERAL EMPLOYER'S I.D. N O .
STATE EMPLOYER'S I.D. NO.
SOCIAL SECURITY N O .
SALES
&
USE TAX PERMIT NO.
901 CODE
CLASS
BIA
-
CODE
COMPLETE IMFORMATlOhl FOR ITEM(S) CHECKED ( - )
1. GROSS RECEIPTS
-
Estimate for first year:
$
2. GROSS PAYROLL
-
Estimate for first year:
$
3. NUMBER OF YEARS LICENSED BY THE STATE OF CALIFORNIA:
4. NUMBER OF PROFESSIONAL EMPLOYEES (LICENSED BY THE STATE):
5. NUMBER OF RENTAL UNITS:
I declare under penalty of perjury that to my knowledge all information contained on this application is true and correct. This tax certificate is for revenue
purposes only and does not imply conformance with applicable city codes and ordinances. You are advised to check your proposed business location and
structure with the City Planning Division for compliance with zoning codes and the Building Inspections Division for compliance with building codes.
SIGN HERE
DATE
TEMPORARY CERTIFICATE
Not Valid More Than 45 Days
from Validation Date
Your Business Tax Certificate will be
sent to you in approximately two weeks.
This Certificate Must Be Renewed
Annually
I
VOID
IF NOT
VALIDATED
Tax
$
B IA
$
TRNIDUP $
PEN
$
TOTAL
$
Mail To: City of Sacramento *915 I Street, Room l214* Sacramento ,CA 95814 (916) 808-8500
WP BT014 (rev 07-05)

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