Schedule C - License Notice For New Business

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CITY OF JACKSONVILLE
320 Church Avenue SE
Jacksonville, Alabama 36265-2651
(256) 435-7611
FAX (256) 435-4103
Schedule C/
License Notice for New Business
DATE:
TO:
Customer #
Code
NAICS
License #
This is to notify you that your business license for the year 2009 for engaging in the business of
_____________________within the City of Jacksonville, Alabama, or within the Police Jurisdiction
th
thereof, is due. The City License is delinquent after the 15
day of business. A penalty of 15% is
th
levied after the 15
day of business (provided for in Section 2 of Ordinance 454).
Each person or entity classified as Schedule C shall pay a license in an amount based on
gross annual receipts for a 12-month period as follows:
$
0.00 to $
100,000.00 . . . . . . . . . . $ 100.00 plus $10.00 issuance fee
$ 100,001.00 to $
500,000.00 . . . . . . . . . . $ 200.00 plus $10.00 issuance fee
$ 500,001.00 to $ 1,000,000.00 . . . . . . . . . . $ 300.00 plus $10.00 issuance fee
$ 1,000,001.00 to $ 5,000,000.00 . . . . . . . . . . $ 500.00 plus $10.00 issuance fee
$ 5,000,001.00 to $ 10,000,000.00 . . . . . . . . . . $1,000.00 plus $10.00 issuance fee
More than $ 10,000,000.00 . . . . . . . . . . $1,500.00 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 Ave SE
Jacksonville, Alabama 36265
Based on an estimated gross annual receipts of $ __________________, I hereby
enclose my payment of $ __________________ (based on the above schedule) plus the
issuance fee of $10.00.
Owner or Authorized Signature
Base fee
$
Please Print Name
Issue fee
$ 10.00
TOTAL
$___________
Name of Company
City, State & zip code
(
)
Telephone

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