Business License Application - City & Borough Of Yakutat - 2011 & 2012

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CITY & BOROUGH OF YAKUTAT
BUSINESS LICENSE APPLICATION
2011
2011 & 2012
City & Borough of Yakutat
State of Alaska Business License #___________
___1 Years…. $25.00 Additional License…$20.00
Tax & License Dept.
___2 Years…$50.00
Box 160
P. O.
Additional License…..$40.00
Yakutat, AK 99689
Check payable to: City & Borough of Yakutat.
Ph. 907-784-3323ext 102 Fax 907-784-3281
Funds are non-refundable. Fill all blanks.
Business Name ___________________________________________________________________________
N a m e m u s t m a t c h t h e n a m e o n t h e S t a t e o f A l a s k a b u s i n e s s l i c e n s e
Mailing Address __________________________________________________________________________
City _________________________________ State _______________________ Zip ___________________
Phone Number ______________________Fax ______________________Toll free ____________________
Physical Location of Business _______________________________________________________________
Is this the same address that the Sales Tax Return will be mailed to? ____Yes ____No. If No, then fill in the
address where the Sales Tax Return will be mailed to:____________________________________________
E-Mail Address_______________________________ Web Page __________________________________
LINE OF BUSINESS: _________________________________Activity Code_________________________
(Please use the State of Alaska Lines of Business & Activity lists.)
If a permit and/or professional licenses are required, list the type of license, name of license holder & number.
________________________________________________________________________________________
What Zoning district is your business located? C__CWR__I___LI___P___R1___R2___R3___RR___NA___
Does your business require a Conditional Use Permit or a Zoning Compliance Permit? YES______NO_____
If you are not sure what zone your business is in or if you need a CUP or ZCP please contact P and Z.
Check all that apply;
This business will pay: Sales Tax 4
Transient Accommodation Tax 8
____Vehicle Rental Tax 8
%
%
%___
____
Business is: (Check One)
□Corporate Corporation Name ________________________________EIN:__________________________
□Sole Proprietorship (One Individual)
Name____________________________SSN_____________________________DOB____________
□Partnership (Provide the SSN of the first two partners, if there are more than two; attach a complete list of
partners and their information on a separate sheet.
Partner
_________________________________________________SSN:_______________________________
Partner
__________________________________________________SSN:_______________________________
This application must be signed & dated by the natural person completing this application on behalf of the business
and state the person’s title of position in the business. I declare, under penalty of perjury, that this application is true
and complete.
________________________________ _________________________ _______________ ______________
Signature
Printed Name
Title
Date
FOR DEPARTMENT USE ONLY
Receipt #__________Initial____Paid___New___Renewal___CBY License__________ST BL____________

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