PD - Business License Application

BUSINESS LICENSE APPLICATION - ELECTRONIC

Revenue Department
275 N Union Avenue PO Box 1987 Ozark, Alabama 36361
Phone: (334) 774-5262 Fax: (334) 445-1054

BUSINESS LICENSE APPLICATION

(CONFIDENTIAL)

LEGAL BUSINESS NAME / DBA:

PHYSICAL ADDRESS:

MAILING ADDRESS:

TELEPHONE:

EMAIL ADDRESS:

BUSINESS ACTIVITIES (Example- Contractor / Sub or General, Retail / Clothing Sales, Wholesale Foods, Equip. Rental, Computer Consulting, etc):

ALATAX ACCOUNT #:

ALATAX TAXPAYER NAME:

STATE CERTIFICATE #: (Required for Automobile Dealer, Beautification, Electrician, General Contractor, Heating / AC Installer, Landscape, Homebuilder / Remodeler, Pawn Shop, and Pest Control)

SALES TAX #:

COMPETENCY CARD # (Required for Plumbers and Plumbing Contractors):

HEALTH DEPT PERMIT # (Required for food services):

FED TAX ID OR SOCIAL SECURITY NUMBER:

CONTACT PERSON NAME:

CONTACT PERSON PHONE:

CONTACT PERSON EMAIL:

LIST NAMES OF OWNER(S), PARTNER, OR OFFICERS NAME / TITLE:

RESIDENCE ADDRESS (Include City, State, and Zip Code):

SSN / DLN:

NAME / TITLE:

RESIDENCE ADDRESS:

SSN / DSN:

NAME / TITLE:

RESIDENCE ADDRESS:

SSN / DSN:

DATE BUSINESS ACTIVITY INITIATED OR PROPOSED IN OZARK, AL:

# OF EMPLOYEES IN OZARK, AL:

This application has been examined by me and is, to the best of my knowledge, a true and complete representation of the above named entity, and persons listed.

EMERGENCY CONTACT NAME:

EMERGENCY CONTACT PHONE NUMBER:

DATE:

PERSON SUBMITTING:

TITLE:

Thanks for submitting!

ADDITIONAL INFORMATION

Please Complete all areas of the form except for the shaded area at the bottom.

Form should be typed or printed legibly.
Form should be dated and signed by an owner, partner, or officer of the business.
From will initiate the process for registering your business with the municipality.

If your business will have a physical location within the municipality, please use that address on the front of this form (Complete separate forms for each physical location in the city).

Upon receipt of the completed form, the municipality will provide any additional forms and information regarding other specific requirements to you in order to complete the licensing process.

All license renewals are due January 1 and delinquent after January 31, with the following exception:

Insurance company license: Due March 1 and delinquent after March 31

THIS FORM IS INTENDED AS A SIMPLIFIED, STANDARD MECHANISM FOR BUSINESSES TO INITIATE CONTACT WITH A MUNICIPALITY CONCERNING THEIR ACTIVITIES WITHIN THAT CITY. A BUSINESS LICENSE WILL BE REQUIRED PRIOR TO ENGAGING IN BUSINESS. IF A BUSINESS INTENDS TO MAINTAIN A PHYSICAL LOCATION WITHIN THE CITY, THERE IS NORMALLY ZONING AND BUILDING CODE APPROVALS REQUIRED PRIOR TO THE ISSUANCE OF A LICENSE. NOTE: It is the business owner's responsibility to check with Zoning Officials regarding restrictions at a possible business location.

IN CERTAIN INSTANCES, A BUSINESS MAY SIMPLY BE REQUIRED TO REGISTER WITH THE CITY TO CREATE A MECHANISM FOR THE REPORTING AND PAYMENT OF ANY TAX LIABILITIES. IF THAT IS THE CASE, YOU WILL BE PROVIDED THE MATERIALS FOR THAT REGISTRATION PROCESS.

THE COMPLETION AND SUBMISSION OF THIS FORM DOES NOT GUARANTEE THE APPROVAL OR SUBSEQUENT ISSUANCE OF A LICENSE TO DO BUSINESS. ANY PREREQUISITES FOR A PARTICULAR TYPE AND LOCATION OF THE BUSINESS MUST BE SATISFIED PRIOR TO LICENSING.

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BUSINESS LICENSE APPLICATION - ELECTRONIC

BUSINESS LICENSE APPLICATION

(CONFIDENTIAL)

ADDITIONAL INFORMATION