New Business License Application - County Of Henrico, Virginia - 2009
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42009
Department of Finance
COUNTY OF HENRICO, VIRGINIA
P.O. Box 90775
Henrico, VA 23273-0775
NEW BUSINESS LICENSE APPLICATION
INSTRUCTIONS: Type or Print providing full information. Return with check payable to “COUNTY OF HENRICO, VIRGINIA.” A Copy will be
returned as your license. For assistance call (804) 501-4310 or visit our website at
ACCOUNT NUMBER
Federal ID or SSN
Retailers
Contractors
Telephone
VA Sales & Use Number
VA State Registration Number
(Assigned by County)
Number
Number
Date business will begin (or began) in Henrico County
/
/
INDIVIDUAL
PARTNERSHIP
CORPORATION
LLC
OTHER
LICENSEE
GIVE A BRIEF DESCRIPTION OF YOUR BUSINESS
TRADE NAME
MAILING ADDRESS
ADDRESS in HENRICO where your business will be conducted
CITY, STATE, ZIP
CITY, STATE, ZIP
FORMULA FOR TAX: GROSS RECEIPTS LESS STANDARD
OFFICE USE ONLY
ZONING approved
disapproved
DEDUCTION OF $100,000 MULTIPLIED BY TAX RATE
COMMENTS:__________________
Entered By:_____________
_____________________________
A MINIMUM PAYMENT OF $30 APPLIES WHEN GROSS
Auditor:________________
RECEIPTS EXCEED $100,000
SIGNATURE: __________________
Date:__________________
DATE:________________________
***THIS FORMULA DOES NOT APPLY TO CLASSIFICATIONS
WITH A FLAT TAX OR WHOLESALE MERCHANTS***
If you operated your business or profession from 01/01/08 to 12/31/08, give the actual amount of
Gross Receipts for the year 2008
$
A
B
LL
USINESSES
If you began after 01/01/08 and prior to 01/01/09, show the actual amount of Gross Receipts for
E
T
L
XCEPT
HOSE
ISTED
the year 2008 and estimate your amount in 2009
B
ELOW
2008 Actual $
2009 Estimate $
TAX RATE (see chart on back)
If you began on or after 01/01/09, please estimate the gross receipts from your start date to
12/31/09
$
C
Actual Gross Receipts from contracts in 2008
Actual Gross Receipts from fees in 2008
ONTRACTORS
(fill in if you did business in 2008)
TAX RATE (see chart on back)
$
$
C
Estimated Gross Receipts from contracts in
Estimated Gross Receipts from fees in 2009
ONTRACTORS
(fill in if you began your business
2009
on or after 01/01/09)
TAX RATE (see chart on back)
$
$
S
B
Actual Cost of Construction in 2008
Estimated Cost of Construction for 2009
PECULATIVE
UILDERS
(use cost of construction exclusive
of land for tax basis)
TAX RATE (see chart on back)
$
$
W
M
Actual Gross Purchases in 2008
Estimated Gross Purchases for 2009
HOLESALE
ERCHANTS
MULTIPLE RATES
$
$
(see worksheet on back)
PEDDLERS – General – $200 Flat Rate
PEDDLERS – Wholesale – Fill in gross purchases for tax basis (see worksheet on back)
PEDDLERS – Perishable – $50 Flat Rate
ITINERANT MERCHANT - $200 Minimum* (see back)
PAYMENT ENCLOSED
$
NEW BUSINESSES: License applications must be received PRIOR to beginning business. The tax shall be paid with the application
for licenses not based on gross receipts. The tax on licenses measured by gross receipts shall be paid within 30 days.
Otherwise,
a 10% filing penalty, 10% payment penalty and 10% interest may be added.
DECLARATION OF TAXPAYER – I declare that the foregoing statements and figures are true, full and correct to the best of my knowledge and
belief.
Signature of Taxpayer_________________________________________________
Date__________________________________
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