Sales Tax License Application Form - City And County Of Broomfield
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1City and County of Broomfield
Sales Tax Administration
ONE DESCOMBES DRIVE
BROOMFIELD, CO 80020
303-464-5811
Email: salestax(~cibroomfieldco.us
Internet : 720-294-9825 (fax)
SALES TAX LICENSE APPLICATION
NO FEE REQUIRED
PLEASE PRINT
CORPORATE NAME Or Name of Sole Proprietor:
DBA/TRADE NAME
(Doing Business As):
BUSINESS STREET ADDRESS:
City
State
Zip
MAILING ADDRESS:
City
State
Zip
TELEPHONE NUMBERS:
(
)
(
(
HOME PHONE:
FAX :
BUSINESS
LOCATION:
)_______________
CORPORATE OFFICE: (
CORPORATE FAX: (
)________________
CONTACT NAME:
TYPE OF OWNERSHIP:
Individual or Sole Proprietor
Partnership
LLC
Corporation
Trust
is a sole
If business
proprietor or partnership, complete the following:
Name, home addresses, home phone, drivers license
State issued, for owner or partners: (Continue on Back)
#,
is a
If business
corporation, LLC or other, complete the following:
Name, titles, and home addresses of corporate officer(s) or managing members(s): (Continue on Back)
Federal Employer Identification No. or Social Security No:
Type of Filing Status:
Monthly, 0
Annual
M
Quarterly, A
=
=
=
State License Number:
Date Business Opened:
Ifphysical location is in Broomfield, please show estimated or actual
sauare footage of store here:
Describe the Nature of Business (Specify type of product sold or type of service rendered):
PRINT NAME
SIGNATURE
DATE
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