CITY OF DAPHNE BUSINESS TAX IDENTIFICATION APPLICATION 
PO Drawer 1047 
Daphne, AL 36526 
251-620-1250 
revenuedept@daphneal.com 
 
Please print or type. See reverse side for instructions & further information. 
 
FORM OF OWNERSHIP:      SOLE PROPRIETOR                                                           PARTNERSHIP                     CORPORATION     LLC           

FEDERAL ID#: ________________________________________________  STATE OF ALABAMA TAX #: _____________________________________________ 

APPLICATION DATE: ________________________  DATE BUSINESS ACTIVITY INITIATED/PROPOSED IN DAPHNE:  _______________________________ 

APPLICATION TYPE:  NEW    RENEWAL                  OWNER CHANGE                                          NAME CHANGE              LOCATION CHANGE      TAX ACCOUNT ONLY 

HOME BASED BUSINESS:    YES        NO        If yes, please complete Home Based Supplement Form provided by Revenue Dept. 

LEGAL BUSINESS NAME: _______________________________________________________________________________________________________________ 

TRADE NAME/DBA (If different from above): ______________________________________________________________________________________________ 

ANTICIPATED GROSS REVENUE FROM START DATE THROUGH DECEMBER 31 (current year):  ________________________________________________ 

PHYSICAL PRESENCE IN CITY LIMITS (i.e. sales/service/deliveries inside Daphne jurisdiction):                                      Yes   No  

BRIEF DESCRIPTION OF BUSINESS ACTIVITIES (i.e retail clothing sales, wholesale food sales, rental of industrial equipment, carpentry contractor, etc): 

______________________________________________________________________________________________________________________________________ 

PHYSICAL ADDRESS:  __________________________________________________________________________________________________________________ 

MAILING ADDRESS:  ___________________________________________________________________________________________________________________ 

BUSINESS PHONE: ____________________________________________  CELL PHONE: __________________________________________________________ 

EMAIL ADDRESS(ES): __________________________________________________________________________________________________________________ 

LIST NAMES OF OWNER(S), PARTNER(S) OR OFFICER(S) (attach separate sheet if necessary): 
NAME                                                           RESIDENCE ADDRESS                                                  SSN                                                TITLE 
______________________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________  

 CONTRACTOR INFO:                                                                                                            CONTRACT AMOUNT$: _________________________  
 Job Location: ___________________________________________________________________________________________________________________ 
 If Sub, Name of General Contractor: _______________________________________________________________________________________________  
 
 Home Builder License #:_____________________  General Contractor Board #: ________________________   HVAC #: _______________________ 
 
 Electrical Contractor #:______________________   Master Plumber #:____________________________  Other: _______________________________
 
This application has been examined by me and is, to the best of my knowledge, a true and complete representation of the above-named entity, and person(s) listed.    
   
______________________________________________________  ______________________________________  _______________________         
Name                                                                                             Title                                           Date 
 
                                                                                                THIS AREA FOR MUNICIPAL USE ONLY 
 DATE:       AMT PAID:                                   CHK / CASH / CC                               BY:                       NAICS CODE:     TAXPAYER ID: 

Please read the following information concerning the completion of this form: 
 
Please complete all areas of the form except for the shaded area at the bottom. 
Form should be typed or printed legibly. 
Form should be dated and signed by owner(s), partner(s), or officer of the business. 
Form will initiate the process for registering your business with the City of Daphne. 
 
If your business will have a physical location within the City of Daphne, please use that address on the front of this form. (Please 
complete separate forms for each physical location in the City.) 
 
Upon receipt of the completed form, the City of Daphne will provide any additional forms and information regarding other specific 
requirements to you in order to complete the licensing process. 
 
All license renewals are due January 1 and delinquent after January 31, with the following exception: INSURANCE COMPANY 
LICENSE: due January 1, delinquent after March 1. 
 
This form is intended as a simplified, standard mechanism for businesses to initiate contact with the City of Daphne concerning their 
activities within the City. A business license will be required prior to engaging business. If a business intends to maintain a physical 
location within the City, there are normally zoning and building code approvals required prior to the issuance of a license. 
 
In certain instances, a business may simply be required to register with the City to create a mechanism for the reporting and payment 
of any tax liabilities. If that is the case, you will be provided the materials for that registration process. 
 
The completion and submission of this form does not guarantee the approval of subsequent issuance of a license to do business. Any 
prerequisites for a particular type and location of the business must be satisfied prior to licensing. 
 
Should there be any questions concerning the completion of this form or the licensing and/or registration process, please call the City 
of Daphne Revenue Department at 251-620-1250 to obtain more detailed information. 
 
                                         City of Daphne Revenue Department 
                                         PO Drawer 1047, Daphne, AL 36526 
                                         251-620-1250  •  revenuedept@daphneal.com 
                                                  www.daphneal.com