Form 08-4514 - Alaska Business License Renewal Application - 2009
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1BUS/TOB
STATE OF ALASKA
Department of Commerce, Community and Economic Development
Division of Corporations, Business and Professional Licensing
BUSINESS LICENSE PROGRAM
P.O. Box 110806
Juneau, Alaska 99811-0806
Phone: (907) 465-2550
ALASKA BUSINESS LICENSE RENEWAL APPLICATION
All business licenses expire on December 31. An annual license expires on December 31 of the year it was purchased. A
biennial license expires on December 31 of the year after it was purchased. Please complete the appropriate section(s) below.
Business License Number: _______________________________
Business Name: _____________________________________________________________________
List the name attached to the Business License Number
If applicable, please provide your professional or occupational license number: ______________________________
Choose license duration:
2009 Annual License, $100
2009/2010 Biennial License, $150
Sole Proprietor, 65 Years or Older (Annual) $50
Date of Birth (required): _________________
Sole Proprietor, 65 Years or Older (Biennial) $75
Date of Birth (required): _________________
Tobacco Endorsement, $100 for each endorsement
List the Tobacco Endorsement Numbers to be renewed (attach additional page if needed):
____________________________
___________________________
___________________________
____________________________
___________________________
___________________________
____________________________
___________________________
___________________________
If applicable, complete the following to update information already on file.
Mailing Address:
________________________________________________________________________
of the principal place of business
Street Address or PO Box
__________________________________________________________________________________________
City
State
Zip Code
Physical Address:
________________________________________________________________________
of the principal place of business
Street Address
__________________________________________________________________________________________
City
State
Zip Code
Business Phone Number: ________________________________________
By signing this application I declare, under penalty of perjury, that this application is true and complete.
Printed name and title of the person completing the application on behalf of the business:
Name: _______________________________________________
Title: _____________________________________
Signature: ___________________________________________
Date: _____________________________________
08-4514 (Rev. 07/27/09)
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Parent category: Legal