License Notice - Schedule E - Jacksonville - Alabama
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1CITY OF JACKSONVILLE
320 Church Avenue SE
Jacksonville, Alabama 36265-2651
(256) 782-3828
Fax (256) 435-4103
Schedule E/
Date:
License Notice
TO:
Customer #
Code
NAICS
License #
This is to notify you that your business license for the year of 2009 for engaging in the business
of
in the City of Jacksonville, Alabama, or within the
th
Police Jurisdiction thereof, is due. The City License is delinquent after the 15
day of business.
th
A penalty of 15% is levied after the 15
day of business (provided for in Section 2 of Ordinance
454).
Each person or entity classified, as Schedule E shall pay a license in an amount based on
estimated gross annual receipts for a 12-month period of business activity as follows:
$
0.00 to $ 49,999.99 . . . . . . . . . . . . $ 75.00 plus $10.00 issuance fee
$ 50,000.00 to $149,999.99 . . . . . . . . . . . . $100.00 plus $10.00 issuance fee
$150,000.00 to $249,999.99 . . . . . . . . . . . . $150.00 plus $10.00 issuance fee
$250,000.00 and over . . . . . . . . . . . . . . . . . $250.00 plus $10.00 issuance fee
th
Plus 1/10
of 1% per thousand in excess of $250,000 ($1.00 per thousand)
Please complete the following statement and submit it together with your payment based on the
above schedule.
Based on an estimated gross receipts of $_________________, I hereby Enclose my payment of
$
(based on the above schedule including the $10.00 issuance fee).
Owner or Authorized Signature
Please Print Name
Certification/Permit Needed
Name of Company
Base fee
$
Mailing Address
Issue fee
$
10.00
City, State & zip code
$1.00 X Gross/1000 $
(
)
(over $250,000)
TOTAL
$
Telephone Number
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