Business Certificate Application - City Of Fontana

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CITY OF FONTANA
• Please Check One •
q q
8353 Sierra Avenue • Fontana, CA 92335 • (909) 350-7675 • Attn: Bus. License
NEW APPLICATION
q q
CHANGE OF OWNER/LOCATION
BUSINESS CERTIFICATE APPLICATION
q q
OTHER
• OFFICIAL USE ONLY •
Business Name
BUSINESS CERTIFICATE NO.
Business Address
EXPIRATION DATE
TOTAL PAID $
o CASH / o CHECK
City
State
Zip
CITY CODE
Mailing Address
SIC CODE
ISSUING CLERK
City
State
Zip
REVIEWED/APPROVED BY: Initial/Date
Business Phone
Business Fax
q q Yes q q No
/
Planning
q q Yes q q No
Email Address
/
Police
q q Yes q q No
/
Building
If business address is located within the City of Fontana please complete 1 thru 3
/
q q Yes q q No
Health
1. Previous use of building?
/
q q Yes q q No
2. Does use involve hazardous or highly flammable materials?
q q
q q
Fire
Yes
No
3. Do you operate more than one business at the above location?
q q
Yes
q q
No
q q Yes q q No
/
Environmental
Description of Business (Various Businesses require additional Police clearance)
q q Yes q q No
/
Other
q q
q q
q q
q q
q q
Ownership:
Corporation
Corp-Ltd Liability
Sole Proprietor
Partnership
Trust
Resale No.
Federal I.D. No.
State I.D. No.
Contractor State License No.
License Type
Expiration Date
Enter below names of Owners, Partners, or Corporate Officers (If applicable, please provide a copy of Articles of Incorporation)
Owner Name
Title
Phone (
)
Home Address
D.O.B.
City
State
Zip
Social Security No.
Driver’s License No.
Owner Name
Title
Phone (
)
Home Address
D.O.B.
City
State
Zip
Social Security No.
Driver’s License No.
PLEASE FILL IN THE APPROPRIATE BOXES BELOW AND SIGN
q q Yes
q q No
Home Based Business:
If yes, mail and phone location only.
$
Estimated Gross Receipts
FOR HOME BASED BUSINESSES, THERE IS TO BE NO STORAGE, SIGNS,
EMPLOYEES, IN/OUT TRAFFIC, LARGE VEHICLES.
NO. OF
RATE
EMPLOYEES
SCHEDULE
NOTICE:
Business certificates are issued pending
Sales or use tax may apply to your
the approval of any or all of the above
business activities.
You may seek
n a m e d R e g u l a t o r y D e p a r t m e n t s .
written advice regarding the application
Business Tax Fee Due
$
Preliminary filing of this application does
of tax to your particular business by
not constitute evidence that the above
writing to the nearest State Board of
d e s c r i b e d b u s i n e s s h a s m e t t h e
E q u a l i z a t i o n o f f i c e .
F o r g e n e r a l
35.00
$
requirements of the Fontana City Code
information, please call the Board of
Application Fee
or Regulatory Agencies of the City of
Equalization at: 1-800-400-7115.
Fontana.
35.00
$
BALANCE DUE
I declare under penalties of perjury that this application and any
attachments thereto, have been examined by me, and to the best of my
knowledge and belief represent a true, correct and complete statement
RETURN APPLICATION TO ABOVE ADDRESS AND
of facts.
MAKE CHECK PAYABLE TO THE CITY OF FONTANA
Signature
Thank you for doing business in the City of Fontana
Title
Date
PLEASE COMPLETE BOTH SIDES OF THIS APPLICATION

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