CITY OF BATON ROUGE
For Office Use Only PARISH OF EAST BATON ROUGE For Office Use Only
Account Number P.O. BOX 2590 Application Number
BATON ROUGE, LA 70821
____________________ PHONE: (225) 389-3084 ____________________
FAX: (225) 389-5369
Email: FinRevInternetEmail@brla.gov
Revised 07/26/2023
Louisiana Tax Number
Federal ID Number
Description of Business
NAIC Number (See List of Business Classes attached)
LEGAL NAME OF BUSINESS
TRADE NAME OF BUSINESS
PHYSICAL LOCATION
(NOT a P.O. Box)
Business Telephone No. ( - )
MAILING ADDRESS
APPLICATION FOR: DATE IN BUSINESS: / / BUSINESS LOCATION:
Sales Tax Registration Taxicab City Limits of Baton Rouge
Occupational License Tax Vehicles for Hire Unincorporated Parish of EBR
Hotel Motel Tax Arborist City Limits of Baker
Insurance Premium Tax Garbage & Trash City Limits of Central
Gross Receipts Tax Online Short-trm Rental Platform City Limits of Zachary
Other ________________ Veteran Owned Business Business Located Outside of EBR
REASON FOR APPLYING:
New Business
Purchased Existing Business? Previous Business Owner:
Trade Owner/Business:
Previous Account Number:
Home Based If checked, Home Based Business Signature form attached and signed
Waste Tire Generator If checked, provide DEQ Waste Tire Generator #___________
FOR OCCUPATIONAL LICENSE ONLY FOR OFFICE USE ONLY
Hotel / Nursing Home / Rooms (# of rooms) x $2 per room = $ Enter as PAY
Security Deposit Due? Yes No Deposit Due: $ Enter as DIR
If business opened less than 30 days ago:
Business opened on or prior to June 30 of current year ( Minimum Payment $50) OR $ MIN (no I&P)
Business opened on or after July 1 of current year ( Minimum Payment $25) OR $ MIN (no I&P)
Professional Business opened any time during the year (Minimum Payment $50) $ MIN (no I&P)
Flat Fee Business $100 / $200 / $250 $ Enter as PAY
If business opened more than 30 days ago (Tax Due for First Year of Business):
Enter Gross Receipts (1 30 days inst business) $ Enter as PAY
Less Allowable Deductions $
Tax Basis (Gross Receipts less Deductions) $
Multiply Tax Basis by # of months in business* $
*(Any month open at least 15 days) Tax Due (Based on applicable Tax Table) $ ABC Account
Penalty $
Interest $ Clearance Issued
*99999999*
Total Due $