Business And/or Sales Tax License Application Form (Page 2 of 2) in pdf

Business And/or Sales Tax License Application Form Page 2

Page 2

Town of Silverthorne

Business and/or Sales Tax License Application

Is your business within the Silverthorne Town Limits? Yes [ ] No [ ]

If yes, please note the physical address of your business:___________________________________________________________

Is your business run out of your primary residence? Yes [ ] No [ ]

If yes you must complete the Home Occupation form: ________

Completed

Name & Title

Address

Telephone (H or W?)

Sales Tax Preparer:

_____________________________________________________________________________

Emergency Contacts:

_____________________________________________________________________________

Partners or Officers in Business

Name

Title

Address

Telephone

Partners or Officers in Business list attached. ________

SUMMIT COUNTY ENVIRONMENTAL HEALTH MUST SIGN OFF ON ANY BUSINESS INVOLVING FOOD 668-4070

I declare under penalty of perjury in the second degree that this application has been examined by me, that the statements made

herein are made in good faith pursuant to the Town of Silverthorne’s Town Code, and to the best of my knowledge and belief are

true, correct, and complete.

Name: (Print) ___________________________________

Title: (Print) _______________________________________-

Signature: _____________________________________

Date: _____________________________________________

STAFF APPROVALS: (DO NOT WRITE IN THIS BOX)

Zoning Official: _______ Date: _________

Building Official: _______ Date: ________

Code Enforcement ________ Date: _______

Date Paid: ___________ Received By: __________________ Check No. _________________

$___________

Business And/or Sales Tax License Application Form Page 2