Occupational Business License Application Form
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3CI TY OF OWENSBORO/DAVI ESS COUNTY FI SCAL COURT
OCCUPATI ONAL BUSI NESS L I CENSE APPL I CATI ON
P.O. BOX 10008
OWENSBORO, K Y 42302
(270) 687-5600
NOTE: I F YOU HOL D A CURRENT CI TY OF OWENSBORO BUSI NESS L I CENSE I T I S NOT NECESSARY TO APPL Y
FOR A DAVI ESS COUNTY FI SCAL COURT BUSI NESS L I CENSE.
1. APPL I CANT I NFORM ATI ON
NAME OF APPLICANT
TRADE NAME OR DBA
2. OWENSBORO/DAVI ESS COUNTY L OCATI ON I NFORM ATI ON
How many locations will this business operate from
? If more than one, attach a Location Information form,
giving the address of each location. The Location Information form is available upon request.
ADDRESS
Owensboro/Daviess County Location (Street)
Zip Code
Business Phone#_____________________________
Email Address:
Mailing Address( if different from Owensboro/Daviess County Location)
Street
City
State
Zip Code
3. CHECK TYPE OF OWNERSHI P
Corporation
Sole Proprietor
Partnership
LLC
LLC
LLC
(Corporation)
(Sole Proprietor)
(Partnership)
* NOTE: Other Business entities may be r equir ed to obtain an Occupational Business L icense
4. CORPORATI ON I NFORM ATI ON
If applicant is a corporation, please list corporate name exactly as it appears on your federal income tax return.
Corporate Name
Date of Incorporation
5. OWNER(S) OF BUSI NESS
If an individual, give name, date of birth, residence address, and social security number; If a partnership,
give this information for each partner; If a corporation, give the same information for the President,
Vice President, Secretary and Treasurer.
Name
Date of Birth
Social Security #
List duly authorized representative of the business who is responsible for operating and managing the business in Owensboro/Daviess County:
Name
D.O.B.
S.S.#
Title
Residence Address
Home Telephone #
Night Emergency #
6. ACCOUNTI NG PERI OD
Calendar Year
Fiscal Year
/
to
/
(please specify beginning of year)
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Parent category: Legal