OFFICE USE ONLY 
                                                                                                        Sales Tax (MQO)     Y    N 
                                                                                                        Lease/Rental Tax      Y   N 
                      CITY OF HOOVER, ALABAMA                                                           Lodgings Tax     Y   N 
                                                                                                        Residential Rental      Y   N 
                             REVENUE DEPARTMENT                                                         Location Code     _______  
                            2020 Valleydale Road   P.O. Box 360628                                     Schedule Number   _______ 
                                  Hoover, Alabama 35236-0628 
                      Phone (205) 444-7516 or (205) 444-7518  Fax (205) 739-7151 
                                  www.hooveralabama.gov 

         APPLICATION FOR CITY BUSINESS LICENSE & TAXES 

                      (Name and address of application is Public Record) 

SELECT THE TYPE OF BUSINESS: 
MANUFACTURER              FINANCIAL, INSURANCE, REAL ESTATE              HEALTH SERVICES 
WHOLESALER                TRANSPORTATION                                 PROFESSIONAL SERVICES 
RETAILER                  PUBLIC UTILITY                                 RESTAURANT 
CONSTRUCTION              INTERNET GAMING                                OTHER 

DESCRIBE BUSINESS: ______________________________________________________________________ 
Sales Representative: Yes    No                        Delivery: Common Carrier           Own Vehicle 
DATE BUSINESS BEGAN IN HOOVER: _________________________________________________________ 
ESTIMATED ANNUAL GROSS RECEIPTS: ______________________ FOR CALENDAR YEAR: ___________ 

SELECT THE TYPE OF ORGANIZATION: 
CORPORATION               LIMITED LIABILITY COMPANY (LLC)                PROFESSIONAL ASSOCIATION 
PARTNERSHIP               SOLE PROPRIETORSHIP                            OTHER (Specify) ____________ 
LEGAL BUSINESS NAME: _____________________________________________________________________ 
TRADE NAME (D/B/A/) ________________________________________________________________________ 
LOCATION OF BUSINESS: 
STREET NUMBER: _________________ NAME OF STREET, RD., etc. _________________________________ 
SUITE NUMBER: ___________ CITY:___________________________ STATE: ___________ ZIP: ___________ 
*Name of shopping center located in Hoover, if applicable:  ____________________________________________
PHONE NUMBER (local) (____)__________________________ FAX NUMBER (____)______________________ 
CONTACT PERSON ______________________________ PHONE NUMBER (emergency) (____)_____________ 
                                       EMAIL ADDRESS ___________________________________  
MAILING ADDRESS (IF DIFFERENT): 
STREET NUMBER: _________________ NAME OF STREET, RD., etc. _________________________________ 
SUITE NUMBER: ___________ CITY:___________________________ STATE: ___________ ZIP: ___________ 
GIVE INFORMATION BELOW, WHERE APPLICABLE: 
SHELBY CO. HEALTH PERMIT #:  _________________________  FEDERAL I.D. TAX  #: _______________________________ 
JEFFERSON CO HEALTH PERMIT #:  ______________________   SOCIAL SECURITY # ______________________________ 
ELEC MASTER CARD #  __________   PLUMBERS MASTER CARD #  ________    HVAC CARD # __________________________   
HOME BLDR CERT #: _________________________  STATE GENERAL CONTRACTOR #: ________________________________ 

THE ISSUANCE OF THIS BUSINESS LICENSE SHOULD NOT BE CONSIDERED AS APPROVAL BY THE CITY 
OF THE LICENSEE’S LOCATION FOR ZONING PURPOSES. 
                                              (OVER) 

ADDITIONAL INFORMATION: 

NUMBER OF EMPLOYEES WORKING IN HOOVER ONLY: 

A. NUMBER OF FULL-TIME EMPLOYEES: _________     B. NUMBER OF PART-TIME EMPLOYEES: ___________ 

ESTIMATED ANNUAL PAYROLL IN HOOVER ONLY: _______________    FOR CALENDAR YEAR: ____________ 

INTERNET SALES:     YES              NO           ESTIMATED GROSS RECEIPTS: ___________ FOR YEAR: _______ 

COMPLETE THE SECTION THAT APPLIES TO THE TYPE OF ORGANIZATION OF YOUR BUSINESS. 

CORPORATION (Attach additional sheet if necessary) 
 NAME/ADDRESS OF ALL OFFICERS OF CORPORATION                                          TITLE                                                               PHONE NO. 
                                                                                                                                                         
LOCATION DATE OF INCORPORATION: ______________________________________________________________________ 
OF INCORPORATION:  STATE: _____________________________      COUNTY: _____________________________________ 

PARTNERSHIP OR LLC (Attach additional sheet if necessary) 
 NAME/ADDRESS OF ALL PARTNERS                                                   TITLE       PHONE NO.                                                    SOCIAL SECURITY NO. 
                                                                                                                                                          OR  
                                                                                                                                                          FEIN 
                                                                                                                                                          
DATE OF FORMATION OF PARTNERSHIP OR LLC: ___________________________________________________________________ 

SOLE PROPRIETOR 
 NAME/ADDRESS OF OWNER                                                          TITLE       PHONE NO.                                                    SOCIAL SECURITY NO. 
                                                                                                                                                          
I hereby certify that all information is true and correct. 

DRIVER’S LICENSE # ____________________     STATE WHERE DRIVER’S LICENSE IS HELD _______________________ 

_________________________________________________                      ___________________________________________ 
                                 SIGNATURE                                                                                                         DATE 

_____________________________________________________ 
                         TYPE OR PRINT NAME 

Comments_______________________________________________________________________________________________ 

                                                           OFFICE USE ONLY 

CLASS          AMOUNT    CLASS          AMOUNT                                              ISSUE FEE ______________ 

______          ______   ______          ________                                           CC FEE        _____________  

______          ______                               ______          ________               TOTAL          _____________