Schedule D - License Notice For New Business
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1CITY OF JACKSONVILLE
320 Church Avenue SE
Jacksonville, Alabama 36265-2651
(256) 435-7611
FAX (256) 435-4103
Schedule D/
License Notice for New Business
DATE:
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
within 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. A
th
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 D 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 $14,999.99 . . . . . . . . . . . . . . $ 75.00
plus $10.00 issuance fee
$15,000.00 to $29,999.99 . . . . . . . . . . . . . . $100.00
plus $10.00 issuance fee
$30,000 and over . . . . . . . . . . . . . . . . . . . . . $150.00
plus 1/10 of 1% on all gross
receipts in excess of $30,000.00
(1/10 of 1% = $1.00 per thousand)
plus $10.00 issuance fee
Please complete the following statement and submit it together with your payment based
on the above schedule.
TO:
City of Jacksonville
DATE:
320 Church Avenue SE
Jacksonville, Alabama 36265
Based on an estimated gross receipts of $______________________, I hereby enclose
my payment of $ ____________________ (based on the above schedule) plus the
issuance fee of $10.00.
Owner or Authorized Signature
Please Print Name
Base fee
$
Name of Company
Issue fee
$ 10.00
Mailing Address
$1.00 X Gross/1000 $
(over $30,000)
City, State & Zip Code
TOTAL
$___________
(
)
Telephone
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