Complete and return form to:
                                                   Revenue Department
                                                   P.O. Box 3065, Mobile, AL  36652-3065
                                                   Phone: 251-208-7462 Fax: 251-208-7954       
Anticipated Start Date ______________________   Email:  revenue@cityofmobile.org
                               BUSINESS LICENSE / TAX APPLICATION
Application Type:        □ NEW □ NAME CHANGE    □  OWNER CHANGE                             □ LOCATION CHANGE
                                              BUSINESS INFORMATION
Legal Business Name:
Principal Business Activity & Product:
Will business be conducted under another name (DBA)?               □ NO           □    YES
If DBA applies, please specify trade name (DBA):
Physical Address (Where the business is physically located & doing business from):
City:                          State:                                             Zip Code:
Business Phone:                Cell Phone:                                        Email:
Contact Person & Title:                         Phone:                            Email:
Mailing  Address:
City:                          State:                                             Zip Code:

Federal Tax ID (FEIN) #:                        State of Alabama Tax #:

Business Structure / Form of Organization:
□ SOLE PROPRIETORSHIP          □ CORPORATION                                      □ LLC
□ PARTNERSHIP                  □ NON-PROFIT CORPORATION                           □ PROFESSIONAL ASSOCIATION
□ OTHER (Please specify):
FILL IN LAND/BUILDING INFO IF PHYSICAL LOCATION IS IN THE CITY OR IT'S POLICE JURISDICTION:
Land / Building          □ OWN □    RENT        If rent, provide a copy of lease & owner information below:
Property Owner Name:                                                              Phone:
Address:
City:                          State:                                             Zip Code:
                             BUSINESS OWNER / APPLICANT INFORMATION

Owners, Partners or Officers (attach separate sheet if necessary): *Copy of Driver's Licenses Must Be Provided*
Name:                          Title:                                             Contact #:
Date of Birth:                 Driver's License #:                                SS #:
Address:
City:                          State:                                             Zip Code:
Name:                          Title:                                             Contact #:
Date of Birth:                 Driver's License #:                                SS #:
Address:
City:                          State:                                             Zip Code:
Name:                          Title:                                             Contact #:
Date of Birth:                 Driver's License #:                                SS #:
Address:
City:                          State:                                             Zip Code:

                                    BUSINESS LICENSE / TAX APPLICATION (PAGE 2)
                                         LICENSING / APPLICABLE TAXES
Business Operated From:              □    HOME                                                              □    STORE FRONT OR OFFICE
Physical Location:        □    CITY  □    POLICE JURISDICTION                                               □    OUTSIDE CITY LIMITS AND POLICE JURISDICTION
Tax Types:
 □    SALES TAX           □    RENTAL TANGIBLE PERSONAL PROPERTY TAX                                                 □    BUSINESS LICENSE (ANNUAL)
 □    CONSUMER'S USE TAX             □    LODGING TAX                                                                □    RENTING RESIDENTIAL PROPERTY
 □    SELLER'S USE TAX               □    WINE TAX                                                                             Please complete page 3 Property List
                                     □    TOBACCO TAX                                                                □    LIQUOR PURCHASE TAX
Tax Filing Frequency (must match your State of AL filing frequency):
 □    MONTHLY     □    QUARTERLY     □    ANNUALLY     □    SEMI-ANNUALLY     □    OTHER
Business Type:
 □    RETAIL              □    WHOLESALE        □    CONTRACTOR                                                      □    SERVICE / PROFESSIONAL
 □    MANUFACTURER        □    RENTAL (tangible goods)          □   RENTAL PROPERTY                                  □    OTHER

                           A separate application is needed if the business will be selling alcohol.
# of Employees  ______              Enrolled in E-Verify?                                                   □ Yes    □    No 
                                                                                                                     If no, please visit www.e-verify.gov
                                         CERTIFICATION AND SIGNATURE
By signing this license application, you certify that all information and statements provided herein are true and correct.  You also 
certify, under penalty of perjury, that you are a US Citizen or are lawfully present in the US.
In addition, by signing below, you acknowledge that you cannot operate this business in the City of Mobile or its Police Jurisdiction 
until this business license application is approved and a business license is issued.

Signature of Owner/Applicant:                                                                                       Date:

Printed Name:                                                                                                       Title:
Name of person completing Application _____________________________________  Title _____________________
             FOR HELP WITH CALCULATION OF LICENSE AMOUNT PLEASE CONTACT OUR OFFICE
                                         LICENSE AND FEE CALCULATION
Effective Date:

          Your Temporary Business License is good for 60 days Only.
After your first 60 days of business, a 60 day affidavit will be due.  This will be used to project your annual
gross which will be used in calculating the amount due for the first years business license.
                You will receive a bill for any amount due less the initial amount paid. 
IF YOU DO NOT TURN IN THE AFFIDAVIT AND OR PAY ANY ADDITIONAL AMOUNT DUE, YOU 
     WILL BE OPERATING WITHOUT A LICENSE.
Note:  All licenses expire Dec. 31st.  To avoid penalty and interest all must be renewed prior to Feb. 1st.
with the exception of insurance which must be renewed by March 1st.
                                    NAICS
Minimum License Amount                                                                                                                   $
Issue Fee                                                                                                                                $ 10
Zoning Fee               $8.00                                                                                                           $
Total Amount Due with Application:                                                                                                       $
          If you need help with this application please contact 251-208-7462
                                    APPLICATION REVIEW  (OFFICE USE ONLY)
Code Compliance:                                                                                           Account #
Application Reviewed By:                 Date:                                                             Date 60 day temp. Lic. Issued:
Business License #                                                                                         Date 60 day affidavit due:
Business License Issued By:                                                                                 Territory - ________________

FOR RESIDENTIAL RENTAL PROPERTY ONLY

PLEASE LIST ALL PROPERTY BY LOCATION:
                                                                        (Office Use Only)
Property Manager/Contract Agent Rental Property Address: Email Address: License #