City Of Mobile, Alabama Business Application Form
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1
2CITY OF MOBILE, ALABAMA BUSINESS APPLICATION
(CONFIDENTIAL)
Complete and Mail or Fax to:
Applicant Complete This Box
FEIN
________________________________
ST of Ala Tax # __________________________
CITY OF MOBILE
Form of Ownership (Check One)
REVENUE DEPARTMENT
P. O. BOX 3065
Sole Prop
Partnership
MOBILE, AL 36652-3065
Corporation
Professional Assoc.
Please Print or Type
LLC
Other ___________
(251) 208-7462
Fax (251) 208-7954
SEE REVERSE SIDE FOR
INSTRUCTIONS AND FURTHER INFORMATION
APPLICATION TYPE:
NEW
OWNER CHANGE
NAME CHANGE
LOCATION CHANGE
Legal Business Name: ____________________________________________________________
Trade Name: (If different from above) ___________________________________________
Business Activities: (Brief descr. - example. retail clothing sales, wholesale food sales, rental of industrial equip. computer consulting, etc)
Physical Address:
__________________________________________________________________
(Street)
(City)
(State)
(Zip)
Mailing Address:
__________________________________________________________________
(Street)
(City)
(State)
(Zip)
Telephone:
_______________________________________________________________________
(Business)
(Fax)
(Home Phone)
Name/Phone # for Contact Person: ________________________________( )___________________
List Names of Owner(s), Partners, or Officers (Attach separate sheet if necessary)
Name
Residence Address
SSN
Title
Date Business Activity Initiated or Proposed in Mobile: ________________# of Employees in Mobile _________
This application has been examined by me and is , to the best of my knowledge, a true and complete representation of the above named entity, and person(s) listed.
Date __________________ Signature _______________________________________________
Title _____________________
THIS AREA FOR MUNICIPAL USE ONLY
ACCOUNT ID # __________________________
REVIEWED BY: ________________________
PHYSICAL LOCATION:
CITY
POLICE JURISDICTION
OUTSIDE CORP LIMITS & PJ
ZONING CLASSIFICATION: _____________________
BUILDING APPROVAL:
YES
NO
N/A
FIRE CODE
TAX TYPES:
SALES/SELLER'S USE
CONSUMER USE
RENTAL
LODGINGS
ALCOHOL
OCCUPATIONAL
TOBACCO
GAS/MOTOR FUEL
BUSINESS LICENSE
TAX FILING FREQUENCY:
MONTHLY
QUARTERLY
ANNUAL
OTHER ________________
BUSINESS TYPE:
RETAIL
WHOLESALE
BUILDING CONTRACTOR
SERVICE
PROFESSIONAL
MANUFACTURER
RENTAL
OTHER_________________
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Parent category: Financial