Occupational Business License Application - City Of Owensboro/daviess County Fiscal Court
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2CITY OF OWENSBORO/DAVIESS COUNTY FISCAL COURT
OCCUPATIONAL BUSINESS LICENSE APPLICATION
PO BOX 10008, OWENSBORO KY 42302
PHONE: (270) 687‐5600 FAX: (270) 687‐8526
1. Check one
New application
Adding a city license to account #
2. Check where business is conducted: Make check payable to "Occupational Tax Administrator"
$ 47 City of Owensboro
$0 Daviess County
Every business or individual subject to the City of Owensboro/Daviess County, KY Occupational License Ordinance is required to complete this
application and return it to the City of Owensboro. WARNING: Any false statement made herein shall be punishable according to law;
and may be cause for denial of the application or the revocation of the business license issued pursuant thereto.
3. Legal Name of Business or Applicant if Sole Proprietor:
4. Doing Business As or Trade Name (if applicable):
5. Brief description of business activity:
6. Primary Business Address or Corporate Headquarters:
7. City of Owensboro/Daviess County Business location:
Contact Name
Contact Name
Address
Address
City
State
Zip
City
State
Zip
Telephone ( )
Telephone ( )
Email
Email
8. Mailing Address for Payroll Withholding Forms:
9. Mailing Address for Net Profit Return:
Contact Name
Contact Name
Address
Address
City
State
Zip
City
State
Zip
Telephone ( )
Telephone ( )
Email
Email
10. Business Entity (Select One):
Sole Proprietor
Partnership
Corporation
LLC ‐ Individual
LLC ‐ Partnership
Non Profit *
* NOTE: Non Profit must attach 501 C(3) Determination Letter from Internal Revenue Service
11. Federal ID No.
AND/OR
Social Security No.
12. Accounting Period:
Calendar Year
Fiscal Year Ending
13. Date Business will begin in the City of Owensboro and/or Daviess County, KY
14. Is Business in the City of Owensboro and/or Daviess County to be:
Permanent
Temporary
If temporary, give approximate dates of activity:
15. When did or will you first pay employees for working in the City of Owensboro and/or Daviess County
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