CITY OF GADSDEN, ALABAMA BUSINESS LICENSE APPLICATION
Phone: (256) 549-4559
Complete and Mail or Fax to: Applicant Complete This Box
(CONFIDENTIAL) Fed ID#___________________________
CITY OF GADSDEN
REVENUE DEPARTMENT Form of Ownership (Check One)
P.O. BOX 267 Sole Proprietor Partnership
GADSDEN, AL 35902-0267 Please Print or Type Corporation Professional Assoc.
SEE REVERSE SIDE FOR INSTRUCTIONS LLC Other
FAX: (256) 549-4561 AND FURTHER INFORMATION
APPLICATION TYPE: NEW RENEWAL OWNER CHANGE NAME CHANGE LOCATION CHANGE
Legal Business Name: _____________________________________________________________________________________________
Trade Name: (If different from above) _____________________________________________________________________
Business Activities: (Brief desc. - example. retail clothing sales, wholesale food sales, rental of industrial equip., computer consulting, etc)
_________________________________________________________________________________________________________________
*Contractors license amount will be based on contract amount (with
Gross Receipts/*Contract Amount: _________________________ the exception of renewals).
Physical Address: __________________________________________________________________________________________________
(Street) (City) (State) (Zip)
Mailing Address: __________________________________________________________________________________________________
(Street) (City) (State) (Zip)
Tax Dept Mailing Address: ____________________________________________________________________________________________
(Street) (City) (State) (Zip)
Telephone: _______________________________________________________________________________________________________
( Business) (Fax) (Home Phone – In Case Of Emergency ) (Cell Phone)
Email: Alatax Acct#: Alatax Taxpayer Name:
Name/Phone # for Contact Person: _________________________________________ ( )_________________________________
List Names of Owner(s), Partners, or Officers (Attach separate sheet if necessary)
Name SSN/Drivers license #/Date of Birth Title
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Date Business Activity Initiated or Proposed in Gadsden: __________________________ # of Employees working in Gadsden __________
Payroll Contact _______________________________________________ Phone number ____________________________
*The City of Gadsden requires a 2% occupational license fee based on gross wages of employees*
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.
Date __________________ Signature ______________________________________________ Title __________________________
THIS AREA FOR MUNICIPAL USE ONLY
ACCOUNT #: _______________ REVIEWED BY:___________________
PHYSICAL LOCATION: □CITY □OUTSIDE CORPORATE LIMITS
ZONING CLASSIFICATION: ___________ BUILDING APPROVAL: □YES □NO □N/A FIRE CODE: _______
TAX TYPES: □BUSINESS LICENSE □OCCUPATIONAL □ALCOHOL TOBACCO □ GAS/MOTOR□ FUEL
□SALES/SELLER’S USE □RENTAL □LODGINGS CONSUMER□ USE
TAX FILING FREQUENCY: □MONTHLY □QUARTERLY □ANNUAL OTHER:□ __________
BUSINESS TYPE: □RETAIL □WHOLESALE □BUILDING CONTRACTOR SERVICE □
□PROFESSIONAL □MANUFACTURER □RENTAL OTHER□ _____________________________