Application For Occupational License - Birmingham Occupational License Department - 2009

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Application for Occupational License
Make Check Payable To:
City of
( )
ALL FIELDS MUST BE COMPLETED
Tax Trust Account
Due: January 1, 2009
Mail to:
Delq: March 1, 2009
RDS
Occupational License Dept.
2009
PO Box 830725
Occupational License Tax
Birmingham, Alabama 35283
Application
Fax Number 205-423-4099
Phone 800-556-7274
Section 1 – Business Information
(
Lines 1 through 11 must be completed in full.)
1.
Date of Application: ___/_____/_____ (Month, Day, Year)
RDS ID: _______________
2.
Application Type:
New Business
Renewal (Provide Prior Year’s License Number): _______________
3.
FEIN/Social Security #________________ LA Sales Tax Number: ___________________Local Sales Tax Number: ___________________
4.
Taxpayer Name: _____________________________ Trade Name/DBA: _________________________Telephone: _____________________
5.
Mailing Address: ____________________________________________________________________________________________________
(Street)
(City)
(State)
(Zip)
6.
Physical Address: ___________________________________________________________________________________________________
(Street)
(City)
(State)
(Zip)
7.
Advise Location of Accounting Records:
(5)=-Mailing Address
(6)=Physical Address
8.
Type of Business (Check One):
Individual
Corp
LLC
Partnership
Professional Assoc
Non-Profit
Governmental
Other (Specify) __________________________
9.
Provide information on owner(s) below. If corporation or partnership, provide information for officers or partners. For Corporation, provide
state of incorporation:
Name
Title
Social Security Number
Resident Address
Telephone Number
Name
Title
Social Security Number
Resident Address
Telephone Number
Name
Title
Social Security Number
Resident Address
Telephone Number
10. Provide Name and address of your agent or attorney who would be served if a suit or charges were filed:
___________________________________________________________________________________________________________________
11. Business Type:
Retail
Wholesale
Bldg Contractor
Service
Professional
Manufacturer
Rental
Other ______________________
Description of Sales or Activity:
(Example: Retail, women’s clothing etc…see enclosed business classification list)__________________________________________________
Section 2 – New Businesses
(Complete this section if you are a new business. To purchase a renewal license skip to Section 3.)
12. New Business Check One:
New Business Started On: _____/_____/_____
Purchased Existing Business-Name Previous Owner: __________________________
Other (Specify) ___________________________
13. Check One Box Below and Follow Instructions to Calculate Taxable Gross Receipts:
Business Opened This Calendar Year
Less Than 30 Days:
Between Dec 2 & Dec 31
Total Gross Receipts for Period of Operation: ___________________
Skip to Section 4 to Calculate Tax Due
Prior to Dec 2: Pay Minimum Tax; Calculate Remainder Due After First 30 Days of Operation Using Method Immediately Below.
More Than 30 Days:
A.
Gross Receipts For First 30 Days:
____________________
B.
Deductions*:
_________________
____________________
C.
(A) Minus (B) Equals Taxable Receipts:
____________________
D.
Number of Months In Operation:
_______
E.
(D) Times (C) Equals Est. Taxable Gross:
____________________
F.
Skip to Section 4 to Calculate Tax Due

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