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Business Registration and Declaration Form

2. Name of Business*

3. Business Type*
   -- Select One --Home Based $25Commercial/Retail/Professional $50Industrial/Warehouse $100

5. Official Start Date*

7. Business Phone Number *

8. After Hours Number*

10. Description of Business*

12. Number of Full Time Employees*

13. Number of Part Time Employees*

15. Does your business sell alcoholic beverages?*
    -- Select One --YesNo

    If yes, send in a copy of your state licence.

16. Does your business sell tobacco products?*
    -- Select One --YesNo

18. Legal Name of Business*

19. Physical Address*

21. Mailing Address*

22. Email Adress*

24. Contact Name*

25. Contact Phone Number*

27. After Hours Contact Person and Phone Number*

    Please notify the City if this information changes during the year.

28. Business Owner's Name and Address*

30. Owner of Building and Contact Information

    (If different from business owner)

32. Total Square Footage under roof

    Including any and all canopies. (does not apply to home based businesses)

34. Signature of Owner or Representative *

    The above information is true and correct to the best of my knowledge.

36. Note:
    Processing can take up to 7-10 business days. A hard copy of your business registration will be mailed to the business address.

    Processing can take up to 7-10 business days. A hard copy of your business registration will be mailed to the business address.

Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field