Alabama Business License/tax Application Form (2007)

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ID#____________
CITY OF PELL CITY, ALABAMA BUSINESS LICENSE/TAX APPLICATION
The City of Pell City, AL Does Not Impose the Business License Tax in its Police Jurisdiction
Applicant Complete This Box
Complete and Mail/Fax/Email To:
SSN OR FEIN # _______________________
CITY OF PELL CITY REVENUE DEPT.
ST of ALA TAX # ___________________
1905 First Ave., No.
FORM OF OWNERSHIP (Check One)
Pell City, Alabama 35125
(CONFIDENTIAL)
Sole Prop. □
Partnership □
Corp. □
Prof Assoc. □
(205) 338-2244
Fax (205) 884-4917
LLC □
Other □_____________
Please Print or Type
SEE REVERSE SIDE FOR INSTRUCTIONS AND FURTHER INFORMATION
Application Type :
New
Owner Change
Name Change
Location Change
Update
Legal Business Name :
___________________________________________________________________________________________
Trade Name or D/B/A: (If different from above) __________________________________________________________________________
Business Activities:(Brief description- Retail clothing sales, wholesale food sales, rental of industrial equip., computer consulting, etc)
________________________________________________________________________________________________________________
Date Business Activity Initiated or Proposed in Pell City, AL: ___________________ # of Employees in Pell City, AL: ____________
Physical Address:
___________________________________________________________________________________________
(Street)
(City)
(State)
(Zip)
M
ailing Address:
___________________________________________________________________________________________
(Street)
(City)
(State)
(Zip)
Telephone:
___________________________________________________________________________________________
(Business)
(Fax)
(Home Phone)
Name & Phone # for Emergency Contact: _______________________________________________(____)_________________________
Email address for Business or Owner:
__________________________________@______________________________
List Names of Owner(s), Partners, or Officers (Attach separate sheet if necessary)
Name
Residence Address
Title
________________________________________________________________________________________________________________
Information and/or documentation required:
Drivers License or other picture identification (Visa, Passport, and Employment Authorization Card); State
License and/or Board Certification when applicable; Corporate certification from the Alabama Secretary of State, and any other documentation as may be
requested by the City of Pell City Revenue Department. This information is used solely for the purpose of determining the correct license classification and is
retained as strict confidential information. This application has been examined by me and is, to the best of my knowledge, a true and complete representation of
the above named entity, and person(s) listed.
Date _______________________ Signature ___________________________________________________Title ___________________________________
THIS AREA FOR MUNICIPAL USE ONLY
ACCOUNT ID # _________________
REVIEWED BY: ___________________
NAICS CLASSIFICATION: _________________
BUILDING APPROVAL:
YES
NO
FIRE CODE APPROVAL
YES
NO
X
X
,
__________________________________________
BUILDING INSPECTOR
______________________________________________, FIRE CHIEF
Tax Types:
Sales/Seller’s Use
Consumer Use
Rental
Lodgings
Alcohol
Occupational
Tobacco
Gas/Motor Fuel
Business License
Tax Filing Frequency:
Monthly
Quarterly
Annual
Other
________________________
Business Type:
Retail
Wholesale
Building Contractor
Service
Professional
Manufacturer
Rental
Other
____________________________
Uniform License Application rev. 04/16/07
Instructions for Completing this form on Reverse Side

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