TOWN OF GYPSUM, COLORADO
                  APPLICATION FOR BUSINESS LICENSE AND/OR SALES TAX LICENSE 
                                                            Revised 1/12/2023

Instructions: A separate application must be filed for each business location in Gypsum. Please complete both sides of application. 

TYPE OF LICENSE APPLIED FOR:              New               Application Dated in: 1 stQtr: $80.00                            Renewal = $80.00 per Year 
                                                                                           2 ndQtr: $60.00 
                                                                                           3 rdQtr: $40.00 
                                                                                           4 thQtr: $20.00  

BUSINESS LICENSE CURRENT BUSINESS LICENSE #: ____________________________ 
Is required for any person to maintain, operate, or engage in any business activity on premises within the Town of Gypsum 

 RETAIL SALES TAX LICENSE (NO CHARGE)    
For both merchants located within the Town of Gypsum and those merchants located outside the Town of Gypsum, but who have 
a sales presence, store, or office, within the Town of Gypsum.  

BUSINESS ACTIVITIES 
Please select business type and all actives to be conducted under this license.
                                                                                          State of Colorado Childcare License:    
  Commercial Retail Location               Home Occupation       Home Office              Please attach a copy of current State Childcare License 
Specify Type Below
                                                                                          Other Licenses: If state or federal agencies license 
         Restaurant  ________________________________________________                     this business, please attach all current licenses held. 

         Bar: _____________________________________________________                       Business licenses must be posted and maintained 
                                                                                          upon the licensed premises in place where it can 
         Lodging:  _________________________________________________                      be seen at all times. Violation of any Town of  
                                                                                          Gypsum Business License Code may be subject 
         Professional:______________________________________________                      to fines of up to $300.00 
         Service: __________________________________________________                      Municipal  Code  Title  5.02  Business  License  is 
                                                                                          available  for  review at          townofgypsum.com or a 
         Other: ____________________________________________________                      copy may be obtained in our Town Hall office. 

Product or Service Sold: ______________________________________________________   

Type of Ownership  :  Sole Proprietor   Limited Liability Company                                Corporation                       Other

If Corporation, Registered Agent: ________________________________________________________________________ 

Trade Name of Business: _______________________________________________________________________________ 

Name of Ownership (If other than trade name): _____________________________________________________________ 
Business Physical Address:                                                      Business Mailing Address: 
                      __________________________________                                            _________________________________  

                       __________________________________                                           _________________________________  

                     ___________________________________                                            _________________________________ 

Business Phone: __________________   Federal ID# _______________________ Colorado Sales Tax # ________________ 

Local Manager-Representative: __________________________________    ______________________________________ 
                                                           Name                                                         Phone #  

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Are you registered with the Secretary of State?   Yes     No                             http://www.sos.state.co.us/ 

                                 SALES TAX REMITTANCE INFORMATION 

Name of person preparing Sales Tax Return ______________________________________  

Select one:  Employee             Accountant/Bookkeeper     Other (specify) _____________________________________ 

Email Address: __________________________________________________   Business Phone: _________________________

             NAMES & HOME ADDRESSES OF OWNERS OR OFFICERS OF BUSINESS 
                                 (Attach additional schedule if necessary) 

Name  ________________________________    Position  ________________________    Home  Phone  __________________ 

Home  Address    ______________________________  City  ______________________  State  __________  Zip  ___________ 

Driver’s Lic #  ________________________  State ________________ Social Security # ___________________________ 

Name ________________________________  Position ________________________  Home Phone __________________ 

Home Address  ______________________________ City ______________________ State __________ Zip ___________ 

Driver’s Lic #  ________________________  State ________________ Social Security # ___________________________ 

Additional PERMITS may be required for any business structural alterations, electrical, mechanical or signage. 

CORPORATIONS ONLY: 
In consideration of the issuance of the Sales Tax License, I _________________,  _________________ 
                                                                                        Officer’s Name               Title
of _______________________________  agree to be individually and personally liable for any sales tax 
             Corporation Name
owed to the Town of Gypsum. This individual, personal liability is in addition to the liability 

of ___________________________________. 
             Corporation Name
By signing below, I declare, under penalty of perjury in the second degree, that this application has been examined by me. That the statements made herein are 
made in good faith pursuant to the Town of Gypsum’s Municipal Code, and to the best of my knowledge and belief, are true, correct, and complete. I am 
attesting that the above listed business is in compliance with all laws of the United States, State of Colorado, and the Town of Gypsum. Also that this business 
or applicant is not in default of any financial obligation in any manner to the Town except current taxes. I also agree this business will comply with all laws and 
regulations applicable to such licensed business and avoid all practices or conditions which do or may affect the public health, morals, or welfare. In addition, 
this licensed business will refrain from operating upon expiration or suspension of this license unless renewed. This business license will be posted and 
maintained upon the premises in a place where it may be seen at all times. 

Signature: _________________________________________  Date:___________________________ 
        (Legally responsible party for the business i.e. owner, partner, officer, etc.) 

Print Name: _______________________________  Title: ___________________________________ 

OFFICE USE: 
TOG Planning Department Approval   __________________    TOG Building Department Approval __________________ 
Additional Requirements for use: ______________________________________________________________________________ 

             Submit Application to:          Town of Gypsum 
                                                      Business License Officer
                                                           PO Box 130 
                                                      Gypsum, CO 81637 
                                                           Phone: (970)524-1721 
                                                      pvenzor@townofgypsum.com
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