Business License Application Form - City Of Leeds, Alabama
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2CITY OF LEEDS, ALABAMA BUSINESS LICENSE APPLICATION
(CONFIDENTIAL)
FEIN:________________________________
Complete and Mail/Fax/E-Mail to:
STATE OF AL TAX#:_____________________
City of Leeds
1040 Park Drive
Leeds, AL 35094
FORM OF OWNERSHIP (CHECK ONE)
Phone 205-699-2585 Fax: 205-699-6558
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E-mail: cityhall@leedsalabama.gov
SOLE PROP:
PARTNERSHIP:
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:
CORPORATION:
PROF. ASSOCIATION
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LLC:
OTHER:
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APPLICATION TYPE:
NEW:
OWNER CHANGE:
NAME CHANGE:
LOCATION CHANGE:
LEGAL BUSINESS NAME:_______________________________________________________________________________________
TRADE NAME:_________________________________________________________________________________________________
BUSINESS ACTIVITIES: (Brief Description – i.e., Retail clothing sales, wholesale, sales conducted outside of building, etc. be thorough!)
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Physical Address:
Street Number:__________________ Street:________________________________________________________________________
City:__________________________________________________________ State:_____________ Zip:_________________________
Mailing Address:
Street Number:__________________ Street:________________________________________________________________________
City:__________________________________________________________ State:_____________ Zip:_________________________
Contact Information:
Business Number:______________________________________ Fax:___________________________________________________
E-Mail:_______________________________________________________________________________________________________
Contact Information:
Name:___________________________________________________ Phone:______________________________________________
E-Mail:_______________________________________________________________________________________________________
List all Owner(s), Partners or Officer(s) (Attach a separate sheet if necessary)
Name
Residential Address:
SSN(if not publicly traded company)
__________________________________
_________________________________
_____________________________________
Date Business was initiated in the City of Leeds:_______________________ Number of employees in Leeds:_________________
This application has been examined by me and is, to the best of my knowledge, a true and complete representation of the above
named/listed entity, and/or person(s).
________________________________________
______________________
_____________________________________
Signature
Date
Title
THIS AREA FOR OFFICE USE ONLY
ACCOUNT ID:_________________________________________ REVIEWED BY:_______________________________________
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PHYSICAL LOCATION:
CITY
POLICE JUSRIDICTION
OUTSIDE CORPORATE LIMITS
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TAX TYPES:
SALES/DELLER’S USE
CONSUMER USE
RENTAL
LODGINGS
ALCOHOL
OCCUPATIONAL
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TOBACCO
GAS/MOTOR FUEL
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TAX FILING FREQUENCY:
MONTHLY
QUARTERLY
ANNUAL
OTHER:___________________________________
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BUSINBESS TYPE:
RETAIL
WHOLESALE
BUILDING CONTRACTOR
SERVICE
PROFESSIONAL
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MANUFACTOR
RENTAL
OTHER:_____________________________
VERSION 201412
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Parent category: Business