Form 08-4181 - Alaska Business License Application
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1
2STATE OF ALASKA
BUS/TOB
Department of Commerce, Community and Economic Development
Division of Corporations, Business and Professional Licensing
BUSINESS LICENSE PROGRAM
P.O. Box 110806
Juneau, Alaska 99811-0806
Phone: (907) 465-2550
ALASKA BUSINESS LICENSE APPLICATION
Alaska statute requires a business license before engaging in business in the State of Alaska. A business subject to
licensing provisions of a regulatory nature must obtain that license before a business license is granted. All business
licenses expire on December 31. An annual license expires on December 31 of the year it was purchased. A biennial
license expires on December 31 of the year after it was purchased. Please complete the appropriate section below.
If applicable, please provide your professional or occupational license number: _________________________________
Choose license duration:
□
□
2009 Annual License, $100
Sole Proprietor, 65 Years or Older (Annual) $50
□
□
2009/2010 Biennial, $150
Sole Proprietor, 65 Years or Older (Biennial) $75
Date of Birth
(Required to receive discount): ____________________
□
Tobacco Endorsement, $100 for each endorsement. Number of Tobacco Endorsement Locations: _______
1. BUSINESS NAME
List the name you will be doing business as (DBA):
2. MAILING ADDRESS
of the principal place of business:
City:
State:
Zip Code:
Business Telephone #:
3. PHYSICAL ADDRESS
of the principal place of business:
City:
State:
Zip Code:
4. OWNERSHIP Information:
Sole Proprietor:
First:
MI:
Last:
(Name of Owner)
Partnership:
First:
Last:
MI:
(Name of Partner)
(Name of Partner) First:
Last:
MI:
Attach separate sheet if necessary
Corporation:
Alaska
(Name of Corporation)
Entity #
Limited Liability Company:
Alaska
(Name of LLC)
Entity #
Limited Liability Partnership:
Alaska
(Name of LLP)
Entity #
5. LINE OF BUSINESS: A separate business license is required for each line of business. The first two digits of the NAICS Code
indicate the line of business. Enter the 6-digit NAICS codes that best describe the activities of the business and the secondary activity
code if any.
Primary NAICS Code:
Secondary NAICS Code:
By signing this application I declare, under penalty of perjury, that this application is true and complete, including any
information provided in the tobacco endorsement section.
Printed name and title of the person completing the application on behalf of the business:
Name:
Title:
Signature:
Date:
For Office
BL Number: ________________
Issued: _________________
By: _______________
Use Only:
08-4181.doc(Rev. 07/27/09)
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