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:                                                                                                                  

 NAICS CODE : ______________ LOOK UP AT https://www.census.gov/eos/www/naics/            
 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) 

  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) 
 
                                                                                                                      SOCIAL SECURITY NO. 
                                                                                                                      OR 
        NAME/ADDRESS OF ALL PARTNERS                           TITLE               PHONE NO.                          FEIN 
                                                                                                                      
  DATE OF FORMATION OF PARTNERSHIP OR LLC:                                                                                                    
 
  SOLE PROPRIETOR 
 
            NAME/ADDRESS OF OWNER                              TITLE               PHONE NO.                          SOCIAL SECURITY NO. 
                                                                                                                      
  COMPLETE AND ATTACH ADDITIONAL INFORMATION SHEET IF IS BUSINESS IS  LOCATED IN THE CITY OF HOOVER 
 
  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                                    PENALTY                                   
 
                                                                               ISSUANCE FEE                              
 
                                                                                   CARD TRANSACTION FEE                   
                                      
                                                                                                         TOTAL               _______________ 

   REQUIRED ADDITIONAL INFORMATION FOR BUSINESSES LOCATED IN THE CITY OF HOOVER ONLY 
                 BUSINESS LICENSE APPLICANTS 
                                                       
  1. TOTAL NUMBER OF EMPLOYEES_______________ 
  2. NON-TAXABLE INTERNET SALES  YES_______NO_____ EST AMOUNT$________________ 
   
                 Requested Local Contact Information 
                                                       
  This information may be used by a public safety official to contact a business representative when 
  there is an incident that warrants their immediate attention. Examples include a fire incident, 
  activation of a fire alarm or other fire protection system, or a public emergency. Local contact 
  information (excluding home address information) may also be used for communications 
  from the City of Hoover's Revenue or Economic & Community Development departments. 
  **Home address information will only be used by public safety officials when there is an urgent 
  incident at the business location or area and attempts to make contact by telephone are 
  unsuccessful** 
   
 Name (Last, First): _________________________________________Title:_____________________________________  

 Business E-mail Address: ______________________________________________________________________________ 

 Daytime Telephone #_______________________ After-Hours Telephone #:_____________________________________ 

 Home Address: _______________________________________________________________________________________       

______________________________________________________________________________________________________ 
 BUSINESS TRADE NAME(DBA) ON LICENSE APPLICATION 

 _______________________________________        ______________________________ 
   
  SIGNATURE OF OWNER OR REPRESENTATIVE           DATE