Occupation Tax Return - The City Of Newnan Page 2
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4NEW BUSINESS APPLICATION
OCCUPATIONAL TAX RETURN
City of Newnan, Finance Department
25 LaGrange Street, PO Box 1193, Newnan, GA 30264
Certificate Number Issued _________________ NAICS Code _____________
GEORGIA SALES TAX NUMBER
GEORGIA STATE CARD
CALENDAR YEAR
______________
Please Fill In All Information COMPLETELY
FEIN
REGISTRATION NO.
PENALTY FOR FAILURE TO FILE RENEWAL BY APRIL 1st EACH YEAR
(A) Estimated
(B)
(C)
(D)
(E)
Disabled Veteran or Not-for-Profit?
Yes
No
Gross
Tax
Tax Rate Per
Admin. Fee
Amount Due
If yes, p
roof of status must be provided with return.
Receipts or
Class
$1,000
MONTH
DAY
YEAR
Flat Rate
BUISNESS TYPE: (check one only)
Date of Business
$20.00
Opening in
Retail
Financial
+
Newnan?
(Bank)
$4.00
Annual (Services)
Insurance
Closed
Business
Notary Fees -
(Column A/1000) X Column C + Column D or
Temporary (one time use)
Date? (temporary
Flat Rate + Column D
check if required
licenses only!)
DESCRIPTION OF BUSINESS ACTIVITIES:
BUSINESS NAME:
BUSINESS LOCATION IN NEWNAN, STREET ADDRESS and ZIP (Not
PO Box)
DBA:
MAILING ADDRESS
ATTENTION:
(if different)
BUSINESS PHONE #
BUSINESS MAILING ADDRESS, CITY, STATE, ZIP
FOR BUSINESS
ADD'L BUSINESS
BUSINESS FAX #
WEBSITE
EMAIL
INFORMATION
BUSINESS TYPE:
CORPORATE N AME, if applicable
PARTNERSHIP
CORPORATION?
STREET OR PO BOX
CITY, STATE, ZIPCODE
CHECK ONE
GA
LLC
SOLE OWNER
OTHER
(Required for each owner) If
OWNER NAME
HOME ADDRESS
CITY, STATE, ZIP
HOME PHONE & EMAIL
more than two owners, see
Pg. 4. Attach list if needed.
OWNER NAME
HOME ADDRESS
CITY, STATE, ZIP
HOME PHONE & EMAIL
Copy of Driver’s
License, SS or Green
Card
MANAGER’S NAME
HOME ADDRESS
CITY, STATE, ZIP
HOME PHONE & EMAIL
Affidavit Verifying
Status
Skip this section - continue on Page 2.
City of Newnan Use Only!
Date Paid: _________________ Amount Paid: _______________
MO
Check#: _____________
Payment Method:
CC
Cash
Processed by: _______________________
Date Processed: _____________ Prior Owner Paid in Full?
Yes
No
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C i t y o f N e w n a n , 2 5 L a G r a n g e S t r e e t , N e w n a n , G A 3 0 2 6 3
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