CITY OF SAINT PAUL  
                                                            P.O. BOX 901 
                                                        ST. PAUL ISLAND, ALASKA 
                                                            99660-0901 
                                                            (907) 546-3121  
                                                            FAX (907) 546-3199 
                       
                    APPLICATION FOR A CERTIFICATE OF REGISTRATION FOR 2016 
The Undersigned makes application for a certificate of authority to collect Sales Tax and submits the following information: 
 
1.  Name of Applicant       
      
          ______________________________________________________________________________________ 
 
Address ______________________________________________________________________________________ 
           
          ______________________________________________________________________________________ 
 
2.  Is this a renewal of a previous registration?       Yes ____  No _____ 

3.  If yes, any changes from previous years?           Yes_____ No _____ 
          If yes, continue completing application. 
          If no, your signature, printed name and application fee complete this application. 

4.  Date Business was started or was purchased by you:________________________________________________ 

5.  Type of Business:____________________________________________________________________________ 

6.  Alaska Business License Number:_______________________________________________________________ 
                                                                      (Fill out a separate application for each ABL Number.) 

7.   Check type of ownership ___Individual ___Co-Partnership ___Corporation ___Other (specify):__________ 

8.  Are       you   the    owner    of  premises        where     your      business  is conducted? Yes____                  No ____: 
     Owner_________________________ 

9.  The following is/are the name(s) and home address(es) of the owner, partners, or corporate officers: 
                    Name                                      Title                            Home address 
                                                                                      
10.  List below all locations where you conduct business: 
                    Name                                                              Location 
                                                 
I HEREBY CERTIFY that the statements made herein have been examined by me, and are to the best of my knowledge and 
belief, true and complete. 
 
Signature                                                     Title 
                                                               
Printed name                                                  Date 
Please submit this form to the City of Saint Paul by January 15 of each year for renewal, or within 24 hours after start of 
business operation within the City limits. A $40.00 fee must accompany this form.