Form: Mun - Municipality Registration Form

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Alabama Department of Revenue
Form: MUN
Business & License Tax Division
Date Received
Severance & License Tax Section
P. O. Box 327550 • Montgomery, AL • 36132-7550
(334) 353-7827
For Department Use Only
Municipality Registration Form
Code of Alabama 1975, Section 11-51-193
PLEASE TYPE OR PRINT YOUR MUNICIPALITY INFORMATION LEGIBLY
Name of Municipality (City or Town)
Telephone Number
(
)
Physical Location (Street)
Physical Location (City & Zip Code)
Mailing Address (Street or P.O. Box)
City
State
Zip Code
Contact Person
E-Mail Address
Telephone Number
Check the box to Indicate Preferred Delivery Method:
U.S. Mail
E-Mail
Signature of Authorized Officer
Date
MAIL TO: Alabama Department of Revenue
Business & License Tax Division
Severance & License Tax Section
P. O. Box 327550
Montgomery, AL 36132-7550
(334) 353-7827
TO BE COMPLETED BY MUNICIPALITIES ONLY
Not to be used to apply for a business license

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