Local Business Tax Receipt Application Form
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1Miami-Dade County
Local Business Tax Receipt Application Form
Apply
On-line at:
OFFICE USE ONLY
Local Business Tax Receipt #:
In person at: The Tax Collector’s Office
200 NW 2
nd
Avenue, Miami
Section/Sub-code:
Miami-Dade Tax Collector
Mail to:
Local Business Tax Section
_
Unincorporated
____Municipality
nd
200 NW 2
Ave
Miami, FL 33128
__ State License
Corp/Fict. Name
Clerk:
Date:
Fax: (305) 372-6368
Info-line: (305) 270-4949
1. BUSINESS INFORMATION: (Additional instructions found at bottom of page.)
a. Business Name/Fictitious Name/ D/B/A:
b. Business Address:
Phone # : (
)
-
Description of location:
Office
Store
Warehouse
Home Office
c. Owner’s/Corporation name (incl. President):
d. Mailing/Owner’s Address:
Phone # : (
)
-
e. Federal Employer ID:
-
or Social Security #:
-
-
f.
Business Start Date:
/
/
g. E-mail Address:
2. NATURE OF BUSINESS:
Maximum number of Employees
Machines/Equipment
Seats
Rooms/Apts.
s
3. SURVEY: Please provide your business NAICS code
This North American Industrial Classification
System codes can be found at
.
4. IDENTIFICATION:
Applicant’s Name (Please print)
Applicant’s Title
Driver’s License Number and State
Applicant’s Signature
1a. Applicants not using full legal name must present proof of their Fictitious Name (see ).
1b. If the business is located within a City, a City Business Tax Receipt is also required; businesses located in
the unincorporated area must also obtain a certificate of use from Planning & Zoning Division (305) 315-2666.
1c. A copy of the certificate of registration of the corporation must be submitted (see
)
1e. Submit a copy of documentation showing a Federal Employer Identification Number or Tax ID Number. If not
applicable, then a copy of a Social Security Card is required.
2. If your business is regulated by a State or County Agency, you must present a copy of an active license. View
requirements at
.
Social Security numbers are solely for compliance with Florida Statute 205.0535: “A (Local Business Tax) receipt
may not be issued unless the federal employer identification number or social security number is obtained from
the person to be taxed.”
All information provided will become part of the public records; however, Social Security
Numbers have protections under confidentiality laws of the State of Florida. [Rev. 9/3/2014]
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Parent category: Financial