Business Registration And Retail Sales Tax Application For: 2010 - City Of Glendale
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4CITY OF GLENDALE
CITY USE ONLY
950 South Birch Street
Sales Tax Account No. __________
New ____ Renewal ____
Glendale, CO 80246
Business License No. ___________
New ____ Renewal ____
(303) 759-1513
(303) 639-4707 FAX
Date Received ________________OPT Yes_______No________
Date Registration Issued ______________Use Tax No._________
Fees Rec’d.
Business $_________ Sales Tax $_________
BUSINESS REGISTRATION AND RETAIL SALES TAX APPLICATION FOR: 2010
A separate application must be filed for each business location in Glendale. This registration is non-transferable if
ownership changes. Registrations are valid from January 1st through December 31st of every calendar year. Complete
ENTIRE Application. (Failure to do so may result in a delay in issuing your license.) Please type or print legibly
The fee for each license is:
Business Registration (REQUIRED by ALL):
$ 10.00
Do you have Retail Sales? YES ___ NO ___
If yes, add:
15.00
Total Enclosed:
$ ________
__________________________________________________________________________________________
BUSINESS INFORMATION
Trade Name “Doing Business As” _______________________________________________________________________________
Glendale Address (if applicable)_________________________________________________________________________________
Name of Corp. LLC, Partnership or other (if applicable)_______________________________________________________________
Home Office Address__________________________________________________________________________________________
City_________________________________________________ State___________________ Zip Code________________________
Contact Person_______________________________________________________________________________________________
Phone Number (______)_____________________________ Home Office Phone Number (______)___________________________
Fax Number (______)____________________________ E-Mail Address________________________________________________
____________________________________________________________________________________________________________
MAILING ADDRESS
Mail To_____________________________________________________________________________________________________
Mailing Address ______________________________________________________________________________________________
City _______________________________________________ State _____________________ Zip Code ______________________
Contact Person_______________________________________________ Phone Number (______)____________________________
____________________________________________________________________________________________________________
Date You Started/Will Start Doing Business In Glendale (MM-DD-YYYY) ______________________________________________
Is Your Business Physically Located in Glendale?
_____ Yes
_____ No
Is Your Business Located in a:
____ Commercial/Retail Complex
____ Office Complex
____ Private Residence
Did You Purchase an Existing Business?
____ Yes
____ No
____________________________________________________________________________________________________________
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