CITY OF MUSKEGON 
                          BUSINESS REGISTRATION APPLICATION 
                              $35.00 REGISTRATION FEE 
                                                    
Enclose the Fire Safety Audit Worksheet with the application.  If you are non-profit, please enclose a copy of your Non-Profit 
Status for waiver of fee.  Return all correspondence to Clerk Office, 933 Terrace St., Muskegon MI 49440. 
 
PLEASE TYPE OR PRINT -FOR QUESTIONS CALL; (231) 724-6705 
BUSINESS NAME:                                      Check one box only: 
                                                    □ 
                                                     Individual               □ Corp   □ Partnership  
                                                    □ Non-Profit              □ LLC    □ Government  
                                                    □ Other (Explain)               □ Single Member LLC  * 
COMPLETE COMPANY NAME: 
 
TYPE OF BUSINESS CONDUCTED: 
 
FEIN#                        HOURS OF OPERATION:                                 NUMBER OF EMPLOYEES: 
                                                                                  
BUSINESS PHONE:                                     START-UP-DATE: 
                                                     
MAILING ADDRESS (for renewal and correspondence): 
 
Number and Street: 
 
City, State, Zip: 
PHYSICAL ADDRESS OF BUSINESS IN MUSKEGON: 
 
Number and Street:  
 
City, State, Zip:  
OWNER/MANAGER:                                       
                                                    TITLE: 
                                                     
DRIVER’S LICENSE NUMBER:                            EMAIL: 
 
RESIDENCE ADDRESS:                                  HOME TELEPHONE: 
                                                     
Number and Street:                                   
                                                    BUSINESS TELEPHONE: 
City, State, Zip:                                    
EMERGENCY CONTACT: 
 
Name:  
 
Address:                                              Phone:  
 
I certify that the above information is correct to the best of my knowledge. 
 
Signature of Applicant                                                                   Date