TOWN OF GYPSUM, COLORADO 
                               APPLICATION FOR BUSINESS AND/OR SALES TAX LICENSE 
 
             A separate application must be filed for each business location in Gypsum. Please fill out completely 
                                                                                                                                       
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.  
 
TOG Planning Department Approval   ____________________    TOG Building Department Approval _________________ 
 
BUSINESS ACTIVITIES 
(Note all activities conducted under this license) 
 
Retail Sales (Specify): _______________________________________                   State of Colorado Childcare License:  Please attach  
                                                                                                           copy of current State Childcare License  
Restaurant/Bar: (Specify Type):  _______________________________                      
                                                                                                                                      Other Licenses: If state or federal agencies license  
Lodging: __________________________________________________                 this business, please attach all current licenses held. 
 
Professional (Specify): _______________________________________                 Business licenses must be posted and maintained 
                                                                                                                                      upon the licensed premises in place where it can 
Service: (Specify Type): ______________________________________                                                                       be seen at all times. Violation of any Town of  
                                                                                                                                      Gypsum Business License Code may be subject 
Other: ____________________________________________________                   to fines of up to $300.00 
                                                                                                                                          
Product or Service Sold: _____________________________________                    Copies of the Business License Code 5.03 are 
                                                                                                                                       available at the Town offices and on our web 
Home Business:            Yes    No                 Internet Business:     Yes    No                                                   page.   www.townofgypsum.com 
 
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): _____________________________________________________________ 
 
Physical Address:                                                                             Mailing Address: 
                                _________________________________                                   ________________________________ 
                         
                               __________________________________                                  _________________________________ 
 
                              ___________________________________                                 _________________________________ 
 
Business Phone: __________________   Federal ID# _______________________ Colorado Sales Tax # ________________ 
 
Local Manager-Representative: __________________________________    ______________________________________ 
                                                                    Name                                                                            Phone # and  
 
Are you registered with the Secretary of State?   Yes                              No                                                      http://www.sos.state.co.us/                           OVER→ 

                               SALES TAX REMITTANCE INFORMATION 
 
Name of person preparing Sales Tax Return ______________________________ Business Phone: ____________________ 
 
Choose one:    Employee         Accountant/Bookkeeper                   Other (specify) _____________________________________ 
 
Email Address: ________________________________________ 
 
              NAMES & HOME ADDRESSES OF OWNERS OR OFFICERS OF BUSINESS 
                                                      (Attach additional schedule if necessary) 
 
Name ________________________________  Position ________________________  Home Phone __________________ 
 
Home Address ______________________________ City ______________________ State __________ Zip ___________ 
 
Social Security # ___________________________ Driver’s Lic #  ________________________  State ________________ 
 
Name ________________________________  Position ________________________  Home Phone __________________ 
 
Home Address ______________________________ City ______________________ State __________ Zip ___________ 
 
Social Security # ___________________________ Driver’s Lic #  ________________________  State ________________ 
 
 ALL SIGNS POSTED MUST BE APPROVED BY THE PLANNING DEPARTMENT 
                                                                        
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. 
 
Signed: _____________________________________  Date: ________________________________ 
(Must be person legally responsible for the business i.e. owner, partner, officer, etc.) 
 
Print Name: _______________________________  Title: ___________________________________  
 
                                                      Mail To:         Town of Gypsum 
                                                             Sales Tax Auditor 
                                                                       PO Box 130 
                                                             Gypsum, CO 81637 
                                                             Phone: (970) 524-1753 
                                                             Fax:     (970) 524-7522