GENERAL INFORMATION FOR PREPARING AN 
                      “APPLICATION FOR TAX CERTIFICATE (ATC)” FORM
                                            CITY OF BIRMINGHAM, ALABAMA
                      FINANCE DEPARTMENT - TAX AND LICENSE ADMINISTRATION DIVISION
                      710 NORTH 20TH STREET, ROOM TL-100 CITY HALL
                                            BIRMINGHAM, AL 35203
                                            (205) 254-2198 OFFICE
                                                    (205) 254-2963 FAX
                                 WEBSITE:  www.informationbirmingham.com

REQUIREMENT TO REGISTER. All persons, firms, corporations, and other legal entities having business activities within the
City of Birmingham are required by law and/or ordinance to register with the City of Birmingham Finance Department. The
attached “Application for Tax Certificate (ATC)” form is used for such registration purposes. THE ATC FORM MUST BE 
COMPLETED FULLY, and must be accompanied by all required documentation as indicated below. (See “Applications for Non-
Controlled Licenses”) Failure to complete the ATC form fully and/or failure to supply the necessary additional documentation may
delay processing of your application which, in turn, may delay receipt of tax forms and/or issuance of your City business license.
If, after reading these instructions, you still have questions about the form, or if you need assistance with completing the form,
please contact our office at (205) 254-2198.

ISSUANCE OF YOUR CITY TAXPAYER IDENTIFICATION NUMBER. Once your fully completed ATC form is received by the
Finance Department, you will be issued a City of Birmingham TAXPAYER IDENTIFICATION NUMBER. This number is to be
used to report all City tax and license liabilities to the City of Birmingham Finance Department. If you have more than one business
location, it is assumed that you will file applicable consolidated returns for Sales Tax, Occupational Tax, Sellers or Consumers
Use Tax, and Lease Tax. Generally, however, each business location requires the purchase of separate business license.

CHANGES OF OWNERSHIP; MERGER; ACQUISITION OF AN EXISTING BUSINESS. If you are currently making application
for a City of Birmingham business license or new City of Birmingham Taxpayer Identification Number as a result of the sale or
purchase of a business, a change of ownership, merger, or other acquisition of a business previously registered to do business
in the City of Birmingham, you must provide information relating to the sale, purchase, merger, change of ownership, or 
acquisition in the relevant section on the ATC form.

PROPER ZONING OF BUSINESS ADDRESS REQUIRED. Each designated business location must be approved by the City
of Birmingham Department of Planning, Engineering and Permits, pursuant to the requirements of Ordinance No. 90-130, as
amended, before a City business license can be issued. In the event that your business relocates from one address within the
City to another address within the City, the new business location must be approved before a City business license can be
issued or renewed.

HOME OCCUPATIONS/HOME OFFICES. Each applicant for a business license who plans to operate his or her business from
a residence within the City of Birmingham must execute a “Home Occupation Certificate of Agreement” through the Department
of Planning, Engineering and Permits before a City business license can be issued. A copy of the properly executed agreement
must be presented to the Revenue Division at the time of making application for licensing. In the event that previously approved
home office relocates from one address within the City to another address within the City, the new home office business location
must be approved before a City business license can be issued or renewed. It is required, therefore, that applications for home
occupations/home offices be made in person at the office of the Tax and License Administration (Revenue) Division located at
710 North 20th Street, Room TL-100, City Hall, Birmingham, AL 35203.

GROSS RECEIPTS LICENSES AND NINETY (90) DAY AFFIDAVITS. All gross-receipts based license amounts are calculated
on twelve (12) months of actual or annualized gross receipts.  New gross-receipts based businesses are generally issued 
a business license in a minimum amount at the time of application.  After the first ninety (90) days of business, a sworn affidavit
attesting to the gross receipts of the business for the first ninety days must be executed. The gross receipts information will be
annualized (projected for the twelve month period), and will provide the basis for calculating the actual business license liability for
the current year and, in some instances, for the second year of operation. Any applicable business license amounts previously
paid will be deducted from the actual business license liability, and you will be billed for any balance due.  

NO PRORATION OF LICENSE RESULTING FROM ABANDONMENT OR DISCONTINUANCE OF BUSINESS. There is no
provision for the proration of any business license taxes as a result of the abandonment or discontinuance of a business.

05-03

LICENSE TO BE EXHIBITED, DISPLAYED, OR POSTED. Each license issued by the Finance Department shall be posted
in a conspicuous place where such business or occupation is carried on, and the holder of such license shall immediately show
such license to the department’s designated agent, or to any police officer of the City upon being so requested by such agent
or officer. Failure to exhibit, display or post such license as required by City ordinance shall be unlawful. Where a license decal
or sticker is required to be affixed to any machine or vehicle, it shall also be the duty of each such licensee to attach and to
keep securely attached such decal or sticker to such vehicle or machine in a conspicuous place.

NON-PROFIT ORGANIZATIONS. Non-profit organizations which have been granted exemptions from business license 
taxation by specific Acts of the Alabama Legislature are exempt from City license taxes. The legislative act or a copy thereof
must be submitted to the Tax and License Administration (Revenue) Division in order to be eligible for such exemption. 
Non-profit organizations are NOT automatically exempt from the provisions of the City of Birmingham Business License Code
by virtue of having qualified for non-profit status on the federal income tax level under the provisions of USC 501(c)(3).

APPLICATIONS FOR CONTROLLED LICENSES. Controlled licenses are granted only through a specific approval process.
Controlled licenses cannot be issued by the Tax and License Administration (Revenue) Division without the proper approval of
specific authorities such as the Birmingham City Council. Such controlled license include the following: Alcoholic Beverage
Licenses; Dance Establishments Serving Alcohol; Dancers and/or Performers in Division II Dance Establishments; Pool Tables;
Junk Yards; and Solid Waste Facilities. IMPORTANT NOTE: APPLICATIONS FOR CONTROLLED LICENSES ARE TAKEN
BY APPOINTMENT ONLY. Please contact the Tax and License Administration (Revenue) Division at (205) 254-2198 for details
of the specific application procedures and prerequisites for such controlled licenses.

APPLICATIONS FOR NON-CONTROLLED LICENSES. If you are applying to register a new, non-controlled business with the
City of Birmingham, please furnish the documents and/or information indicated below:

1. All Applicants - Furnish the completed and signed “Application for Tax Certificate (ATC) Form”.
2. Sole Proprietorships, Partnerships - Furnish copy/copies of valid drivers license of sole proprietor and/or all partners.
3. Alabama Corporations    - Furnish copies of Articles of Incorporation filed with the Alabama Secretary of State and a
   copy or copies of valid driver’s licenses of principal officers.
4. “Foreign” Corporations (Incorporated in a state other than Alabama) - Furnish copies of Articles of Incorporation; 
   Copy of your letter of authorization to do business in the State of Alabama obtained from the Alabama Secretary of State;
   and, a copy or copies of valid driver’s licenses of principal officers.
5. Food/Eating Establishments - Furnish a copy of a valid Health Department Permit. Such businesses include restaurants,
   lounges, food stores, convenience stores, snack bars, mobile food vendors, etc.
6. Day Care Centers - Furnish valid “Zoning Certificate of Operation (ZCO); and copy of County or State Day Care License
   (issued through the County or State Department of Human Resources).
7. Home Occupations/Home Offices - Furnish copy of “Home Occupation Certificate of Agreement”. Contact Larry Young
   of the Department of Planning, Engineering and Permits at (205) 254-2211.
8. State Certified, State Regulated, or State Licensed Occupations - Furnish copies of evidence of State licensing, or
   State certification cards for the following occupations: Burglar Alarm Companies (Installation and Monitoring); Master
   Electricians; Master Plumbers; Master Gas Fitters; Master Plumbers and Gas Fitters; Heating and Air Conditioning (HVAC)
   Contractors; Tree Pruning and/or Tree Surgery; and Landscape Architects or Landscape Gardeners.
9. Transient Vendors/ Special Events Licenses      - Contact the Tax and License Administration (Revenue) Division at 
   (205) 254-2198 for details of the specific application procedures and prerequisites for issuance of such licenses.
10.  Other - If you are unsure whether your business requires special certification, licensing, or approval, please contact the
   Tax and License Administration (Revenue) Division for additional information at (205) 254-2198.

REQUEST FOR RULING ON DETERMINATION OF TAXATION. Any taxpayer or applicant may request a ruling on 
the determination of whether amounts of gross sales, or gross receipts of his/her business are subject to the license tax, or are not
to be used as a measure of the license taxes due and payable as levied by the Business License Code of the City of
Birmingham. Such requests shall be made in writing to the Finance Department, and shall contain all pertinent facts relating 
to the item(s) in question.

CONFIDENTIALITY OF APPLICATION AND TAX RETURNS. Information supplied to the department in the form of applica-
tions and tax returns is subject to the confidentiality provisions outlined in Ordinance No. 97-183, “The Business License Code
of the City of Birmingham”, Article II, Section 14.

COMPLETE AND RETURN THIS FORM TO:                                                                     TAXPAYER IDENTIFICATION NUMBER
City of Birmingham-Revenue Division                                                                       (City Office Use Only)
710 North 20th Street-Room TL 100
Birmingham, AL 35203
(205) 254-2198 Office                               CITY OF BIRMINGHAM
(205) 254-2963 Fax
www.informationbirmingham.com         APPLICATION FOR TAX CERTIFICATE

The information that you provide in this application is protected by the confidentiality provisions outlined in Ordinance No. 97-183, “The
Business License Code of the City of Birmingham”, Article II, Section 14. Please type or print. This application should be completed fully
to avoid delays in processing.

Section 1 – WHAT WOULD YOU LIKE TO DO?
● ● Register a new business (Please complete all sections)
● ● Add a New Location or Tax Type to your current registration (Please complete Sections 2, 3, 5-10, 12,13, and 14)
● ● Change Business Ownership of your current registration (Please complete all sections)
● ● Change the Mailing Address only for your current registration (Please complete Sections 2, 8-10, 12, 13 and 14)
● ● Change the Location Address of your current registration (Please complete Sections 2, 3, 5-13, and 14)
● ● Change in Corporate Officers, Members, or Partners (Please complete Sections 2, 5, 7-9, 11-13, and 14)
● ● Provide a general “update” of your current registration information (Please complete all sections)

Section 2 – LEGAL NAME AND MAILING ADDRESS to which tax forms are to be sent:
(Note: If mailing address is a post office box, the street address of the business must also be indicated.)

Full Legal Name _____________________________________________________________________________________________
Attention: ___________________________________________________________________________________________________
Address ____________________________________________________________________________________________________
___________________________________________________________________________________________________________
City ________________________________________________________  State  ______  Zip Code  ____________ - ____________
Area Code and Phone Number __________________________________________________________________________________
Area Code and Fax Number ____________________________________________________________________________________
Name of Contact Person_______________________________________________________________________________________
E-Mail_______________________________________  Website Address ________________________________________________

Section 3 – TRADE NAME AND LOCATION ADDRESS of office in Birmingham. If you are registering more than one location,
please see reverse side of this form. (Important Note: All business locations are subject to zoning approval.)

Please select:        ● ●  Commercial Establishment    ● ● Private Residence ● ● No Physical Birmingham Location

Trade (d/b/a) Name ___________________________________________________________________________________________
Attention: ___________________________________________________________________________________________________
Address ____________________________________________________________________________________________________
___________________________________________________________________________________________________________
City ________________________________________________________  State  ______  Zip Code  ____________ - ____________
Area Code and Phone Number of Business Location_________________________________________________________________
Area Code and Fax Number of Business Location___________________________________________________________________
Name of Contact Person at Business Location______________________________________________________________________
E-Mail_______________________________________  Website Address ________________________________________________

Section 4 – CHANGE OF OWNERSHIP resulting from merger, purchase or acquisition of an existing business.
If applicable, this section MUST be completed.

Former Owner __________________________________________  Birmingham Taxpayer ID Number________________________
Trade (d/b/a) Name ___________________________________________________________________________________________
Mailing Address of FormerOwner_________________________________________________________________________________
___________________________________________________________________________________________________________
Address(es) of Former Location(s) _______________________________________________________________________________
___________________________________________________________________________________________________________
Area Code and Phone Number of Former Owner ___________________________________________________________________

APPLICATION FOR TAX CERTIFICATE  (CITY OF BIRMINGHAM, ALABAMA)                                                                    2

Section 5 – TYPE OF OWNERSHIP
Please indicate the form of organization. NOTE: Please refer to the accompanying “General Information for Preparing an Application
for Tax Certificate Form” instruction sheet for a listing of supplemental documentation to be included with this application.

● ●  1. Alabama Corporation (Incorporated in Alabama)    ● ● 1. Foreign Corporation (Incorporated in another state)
● ●  2. Partnership (two or more owners)
● ●  3. Sole Proprietor (one owner)
● ●  4. Unincorporated Association (i.e., PA)
● ●  5. Other ________________________________
● ●  6. Limited Liability Partnership (LLP)
● ●  7. Limited Liability Company (LLC)

Section 6 – TYPE OF BUSINESS
Please indicate the principal business activity category.
                                                         ● ● 8. Home Occupation/Home Office 
● ●  1. Manufacturer                                                  (Please specify the type of occupation or office)
● ●  2. Contractor (Please specify) _______________                   ________________________________________________
● ●  3. Wholesaler                                       ● ● 9. State Certified, State Regulated, or State Licensed 
                                                                      Occupations (Please specify) ______________________
● ●  4. Retailer
                                                         ● ● 10. Transient Vendors/Special Events:
● ●  5. Other  (Please specify)___________________                    Date(s) of the Event 
● ●  6. Food/Eating Establishment                                     Event Location 
● ●  7. Day Care Center

Section 7 – PRINCIPAL BUSINESS ACTIVITY AND PRODUCT
You should indicate the one business activity that accounts for the largest percentage of gross income. State the broad field of business
activity as well as the product or service. For example—Activity: Wholesale Sales / Product: Pharmaceuticals OR  Activity: Manufacturing /
Product: Automobiles. Note: This information should be the same information as required by the Internal Revenue Service on Schedule C of
Form 1040 for Sole Proprietorships.

Activity _______________________________________________  Product ______________________________________________

Section 8 - FEDERAL TAX ID NUMBER / NUMBER OF EMPLOYEES
Enter Federal Identification Number (REQUIRED) and the number of employees that will be working in Birmingham.

Federal ID Tax Number  __________________________________   Number of Employees in Birmingham (Required)_____________

Section 9 – COMMENCEMENT OF BUSINESS ACTIVITY

Enter Date Business Activity Will Begin in Birmingham: Month _____________ Day ______ Year _______

Enter Date City of Birmingham Taxpayer Identification Number Applied For: Month _____________ Day ______ Year _______

Section 10 – TAX LIABILITIES Check the taxes for which you are liable.

■ ■  Sales Tax                               TAX  IDENTIFICATION NUMBERS NOW ASSIGNED TO YOU: (Write “None” if no number assigned)
■ ■ Sellers Use Tax
■ ■ Consumers Use Tax                        State of Alabama Sales Tax Number
■ ■ Lease Tax                                State of Alabama Sellers Use Tax Number 
■ ■ Occupational Tax                         State of Alabama Consumers Use Tax Number
—Employer’s                                  State of Alabama Lease Tax Number
■ ■ Lodgings Tax                             State of Alabama Lodgings Tax Number 
■ ■ Business License Tax                     State of Alabama Unemployment Tax Number

If you have more than one business location, it is assumed that you will file consolidated returns for each of the taxes for which
you may be liable, including sales, use, lease, occupational, and lodgings taxes. Each separate business location requires a
separate business license.

APPLICATION FOR TAX CERTIFICATE        (CITY OF BIRMINGHAM, ALABAMA)                                               3

Section 11 – OWNER, PARTNERS, MEMBERS, OR CORPORATE OFFICERS
This information REQUIRED. (Attach additional sheets if necessary.)

        NAME                                               TITLE                          SOCIAL SECURITY NUMBER
                                                                                              –                –
                                                                                              –                –
                                                                                              –                –
                                                                                              –                –
                                                                                              –                –
                                                                                              –                –

Section 12 – CORPORATE RESIDENT AGENT OR LOCAL MANAGER

Name ______________________________________________________________________________________________________
Address of Residence _________________________________________________________________________________________
___________________________________________________________________________________________________________
City _______________________________________________________________ State ______  Zip Code _________ - _________
Area Code and Phone Number of Residence

Section 13 – STATEMENT OF ACKNOWLEDGEMENT AND ACCEPTANCE OF CONDITIONS – Please read carefully, then sign.

I declare, under the penalty of making a false declaration, that I am authorized to complete this form and to the best of my knowledge
and belief all questions answered are true, correct, and complete statements, made in good faith. I understand and agree that the granting
of this license requires my compliance with all applicable City of Birmingham Tax Code provisions, and state laws, as well as with all
conditions set forth in any and all applicable City of Birmingham Laws, Ordinances, Rules and Regulations, and that any failure or refusal
to comply with said laws, ordinances, rules and regulations may result in the revocation of any license issued pursuant to this application.
I also understand that disclosure of any false or misleading information will result in automatic denial of any license issued pursuant to
this application, or in the revocation of the license if such has already been issued. I understand that it is unlawful for any person to 
commence or engage in any business, vocation, occupation or profession, who is not otherwise exempt therefrom under the provisions
of the City of Birmingham Business License Tax Code (Ordinance No. 97-183), without first having procured a license therefor, and that
it is unlawful for any person to continue in any business, vocation, occupation, or profession after the expiration of a license previously
issued, without obtaining a new license. I further understand that it is unlawful for any person to engage in or to continue in any 
business, vocation, occupation, or profession at any location within the corporate limits of the City of Birmingham without approval from
the City of Birmingham Department of Planning, Engineering, and Permits (Zoning Division).

Signed:

_______________________________________________________            __________________________________________
       Signature of the Person Completing This Application                                    Date

_______________________________________________________            __________________________________________
    Print the Name of the Person Completing This Application       Phone Number of Person Completing Application

CITY OFFICE USE ONLY – Location _____

                                                                   SIC OR NAICS ______________________________________
        ZONING APPROVAL AND COMMENTS:                              BLIC ______________________________________________
__________________________________________________                 TERRITORY ________________________________________
__________________________________________________                 ANNEX____________________________________________
__________________________________________________                 HEALTH DEPT PERMIT_______________________________
                                                                   OTHER REQUIRED PERMIT___________________________
    HOME OCCUPATION CERTIFICATE EXECUTED                           ARTICLES OF INCORPORATION_______________________
■ ■ YES ■ ■ NO ■ ■ NOT APPLICABLE                                  CERTIFICATE OF AUTHORITY_________________________
                                                                   TAX FORMS ORDERED      ■ ■ NBL ORDERED       ■ ■

APPLICATION FOR TAX CERTIFICATE  (CITY OF BIRMINGHAM, ALABAMA)                                                                  4

SECTION 14 – ADDITIONAL TAXABLE LOCATIONS

Trade Name and Location Address of office in Birmingham. If you are registering more than one location, please use this section.
Attach additional sheets if necessary. (Important Note: All business locations are subject to zoning approval.) Location__________

Please select: ● ● Commercial Establishment ● ● Private Residence ● ● No Physical Birmingham Location
Trade (d/b/a) Name ___________________________________________________________________________________________
Attention: ___________________________________________________________________________________________________
Address ____________________________________________________________________________________________________
___________________________________________________________________________________________________________
City _______________________________________________________________ State ______  Zip Code _________ - _________
Area Code and Phone Number of Business Location_________________________________________________________________
Area Code and Fax Number of Business Location___________________________________________________________________
Name of Contact Person at Business Location______________________________________________________________________
E-Mail_____________________________________________  Website Address_________________________________________ 

CITY OFFICE USE ONLY – Location _______
                                                          SIC OR NAICS ______________________________________
        ZONING APPROVAL AND COMMENTS:                     BLIC ______________________________________________
__________________________________________________        TERRITORY ________________________________________
__________________________________________________        ANNEX____________________________________________
__________________________________________________        HEALTH DEPT PERMIT_______________________________
                                                          OTHER REQUIRED PERMIT___________________________
    HOME OCCUPATION CERTIFICATE EXECUTED                  ARTICLES OF INCORPORATION_______________________
■ ■ YES            ■ ■ NO              ■ ■ NOT APPLICABLE CERTIFICATE OF AUTHORITY_________________________
                                                          TAX FORMS ORDERED  ■ ■ NBL ORDERED         ■ ■

Trade Name and Location Address of office in Birmingham. If you are registering more than one location, use this section. Attach
additional sheets if necessary. (Important Note: All business locations are subject to zoning approval.)  Location_________

Please select: ● ● Commercial Establishment ● ● Private Residence ● ● No Physical Birmingham Location

Trade (d/b/a) Name ___________________________________________________________________________________________
Attention: ___________________________________________________________________________________________________
Address ____________________________________________________________________________________________________
___________________________________________________________________________________________________________
City _______________________________________________________________  State ______  Zip Code _________ - _________
Area Code and Phone Number of Business Location_________________________________________________________________
Area Code and Fax Number of Business Location___________________________________________________________________
Name of Contact Person at Business Location______________________________________________________________________
E-Mail_____________________________________________  Website Address_________________________________________ 

CITY OFFICE USE ONLY – Location _______
                                                          SIC OR NAICS ______________________________________
        ZONING APPROVAL AND COMMENTS:                     BLIC ______________________________________________
__________________________________________________        TERRITORY ________________________________________
__________________________________________________        ANNEX____________________________________________
__________________________________________________        HEALTH DEPT PERMIT_______________________________
                                                          OTHER REQUIRED PERMIT___________________________
    HOME OCCUPATION CERTIFICATE EXECUTED                  ARTICLES OF INCORPORATION_______________________
■ ■ YES            ■ ■ NO              ■ ■ NOT APPLICABLE CERTIFICATE OF AUTHORITY_________________________
                                                          TAX FORMS ORDERED  ■ ■ NBL ORDERED         ■ ■