NEW ACCOUNT REGISTRATION FORM                           Avenu Account No. ___________ 
                                                                    ALL FIELDS MUST BE COMPLETED                            Name of Municipality:  
                                                                    Application must be signed by Applicant                                                                 
                                                                    One Application per Physical Location per Municipality  _________________________ 
                                                                                                                                                                                                                          
        For most tax types, online filing is available at www.salestaxonline.com or www.hoteltaxonline.com. Visit www.avenuinsights.com for more information. 
 
Application Type (Check One):  ____New Business  ___Renewal  ___Name Change   ___Owner Change   ___Location Change      
 
Legal Business Name: _____________________________________________________________________________________________________________ 
 
Trade Name / DBA (If different from legal name): ________________________________________________________________________________________ 
 
Business Mailing Address:  (Street)   __________________________________________________________________________________________________ 
        
   City_____________________________________________ State______ Zip _______________ County __________________________________________ 
 
General Contact Information:  Name ___________________________________________________________ Title: ________________________________ 
 
    Cell Phone: ______________ Alternate Phone:_______________  Email Address: ___________________________________________________________ 
 
    Would you prefer to communicate with us in Spanish?     ___Yes    ____No                       Would you prefer electronic communication when available? ___Yes    ____No 
 
Date Business Activity Initiated/Proposed: __________________ Local No. of Employees: _________  No. of Employees Company-Wide:_________________ 
 
Ownership Information:   
      Form of Ownership (Check One      ):  ____Sole Proprietorship*   ____Corporation  ____LLC-Single Member  ___LLC -Multi Member ____General Partnership 
 
                ___ LLP (Limited Liability Partnership)    ____Governmental Agency      ____ Professional Association  ____Other: __________________________ 
 
Federal Employer Identification Number (FEIN):____________________________*Social Security Number: ________________________________________ 
                *Note: Sole Proprietors must provide SSN. All other businesses must provide either SSN or FEIN on application per Act 2014-430. 
 
Owner(s), Partners, or Officers Information (Attach Separate Sheets if Necessary; (Residential Addresses Only– No PO Boxes) 
 
1. Name: _________________________________________________  Title: _____________________________________________ SSN:_______________ 
 
   Address: ________________________________________________ Email :____________________________________________ Phone:______________ 
                                       
2. Name: _________________________________________________  Title: _____________________________________________ SSN:_______________ 
 
   Address: ________________________________________________ Email :____________________________________________ Phone:______________ 
 
Business Description/Information – (To Be Completed for Each Physical Location, Street Address Only - No PO Boxes )  Residential Address (Choose One)                       ___Yes   ____No 
 
     Doing Business As for this Physical Location: _______________________________________________________________________________________ 
 
     Physical Street Address: ____________________________________ City______________________ State_____ Zip ________ County _______________ 
      
     Telephone: _______________________Website: __________________________________________Email:_____________________________________ 
                                                      
     Physical Location (choose one):   ____ Incorporated City Limits                ____Police Jurisdiction            ____Outside Corporate Limits & Outside PJ     
 
     Business Type (choose one): ___Retail  ___Wholesale  ___Building Contractor  ___Service  ___Professional ___Manufacturer ____Rental ___Delivery Only 
      
     Describe the business you are conducting:________________________________________________________________ NAICS Code:______________ 
                                                                                                                                       www.naics.com 
Indicate the tax types required for each physical location.           (Use additional sheets if necessary)   
 
    Types (indicate all needed):   ____ Sales Tax   ____ Sellers Use ____Consumers Use ____Rental Tax ____Lodgings Tax  ____Alcohol Tax ____Tobacco   
 
     ____Occupational ____Gas/Motor Fuel ____Business License/Certificate ____Permit ____BID/DID ____Other   AL Sales Tax No: ____________________ 
    
    Rates (indicate all needed):  ____General Rate  ____ Automotive Rate  ____ Mfg. Machine Rate  ____Agricultural Rate  ____Amusement Rate  ____Vending  
 
      Note: Your municipality may require the purchase of a Business License in order to conduct business in addition to filing other tax types. Online filing for business licenses for municipalities administered by  
       Avenu is available at https://rds.bizlicenseonline.com. See www.avenuinsights.com for more information. 
Contact Information for this location: 
             
      Name _____________________________________________________ Title:_______________________________ Cell Phone: ____________________ 
 
       Email Address: ________________________________________________________________________________Alternate Phone: _________________ 
Sworn Statement:  This application has been examined and is, to the best of my knowledge, a true and complete representation of the above-named entity and 
person(s) listed.  Failure to complete the application in full, sign, and date this application will make the application invalid.   
 
Signature: _____________________________________________________ Title: ___________________________________ Date: ____________________ 
 
Print Name: ____________________________________________________ Email: _________________________________ Telephone No.: _____________ 
Returned Check Disclaimer:  Effective July 1, 2010, each returned item received by Avenu due to insufficient funds will be electronically represented to the presenters’ bank no more than two times to obtain 
payment. Avenu is not responsible for any additional bank fees that will accrue due to the resubmission of the returned item. Please see the full returned check policy at www.avenuinsights.com. 
 
For assistance: Email: rdssupport@avenuinsights.com   Website: www.avenuinsights.com     Toll Free Phone: (800) 556-7274    Toll Free Fax: (844) 528-6529    Se habla español.