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CITY OF EVANS, COLORADO
BUSINESS AND SALES TAX LICENSE APPLICATION

BUSINESS AND SALES TAX LICENSE FEE: $25.00 Annual Renewal Due NOT LATER THAN December 31st
AFTER EXPIRATION DATE, RENEWAL FEES INCREASE TO $50.00
Important: Please keep a copy of this application for your records.
Mail to: For City Use Only
Monthly Sales Tax License
City of Evans Quarterly General Registration
BUSINESS AND SALES TAX OFFICE Annual NAICS Code
1100 37th Street GEO Code
EVANS, CO 80620
(970) 475-1109 Amount Paid:
(970) 330-3472 Fax Check No.
salestax@evanscolorado.gov Property Zoning:
www.evanscolorado.gov Zoning Approval:
PLEASE TYPE OR COMPLETE IN BLACK INK. PLEASE COMPLETE APPLICATION IN FULL
(Illegible and/or incomplete forms may be rejected)
SECTION ONE - All information provided in this section of the application is considered public information and is required to be released upon
public request.
1. Type of Ownership: Sole Proprietor Partnership Corporation Limited Liability Corp. Other
2. Taxpayer Name (Owner, Partners or Corporate Name):

3. Trade Name ("Doing Business As"):

4. Business Address:
Street City State Zip
5. Mailing Address:
Street/ Post Office Box (If Different than Business Address) City State Zip
6. Business Phone No: First Day of Business in Evans: / /

7. Web Site Address: E-mail Address:(required)

8. Nature of Business (Check all that apply): Wholesale Manufacturing Construction Service Retail
Office Only Mail Order Communications/Telecom Finance/Insurance/Real Estate
9. What is your main product/service?

10. Do you sell, distribute, deliver, or grow Medical Marijuana? Yes No

11. Is this business in a: Commercial Building Private Residence (if private residence, fill out Home Occupation Certificate form)
12. If a private residence, do your customer come to your home? Yes No
13. If located in Evans, what are your hours of operation?
14. If located in Evans, approximate sq. ft. of business:
15. If located in Evans, no. of employees (include self): Full Time Part-time

16. Do you have other locations in Evans? Yes No
If "YES", a separate application must be completed per business location.

17. Contact Person:

Address City State Zip Phone Email (required)

**PLEASE COMPLETE FRONT AND BACK OF APPLICATION**

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Business and Sales Tax License Application (con't)
SECTION TWO - All information provided in this section of the application is considered confidential.

18. Filing Frequency:    $300 tax/month or more, file monthly
                         Under $300 tax/month, file quarterly
                         $300 tax/year or less, file annually
19. List Owner(s) or Corporate Officers: (attach supplemental sheet if necessary)

    Name                                                         Position                                                      Home Phone

    Home Address                                                 City                      State                               Zip code

    Name                                                         Position                                                      Home Phone

    Home Address                                                 City                      State                               Zip code

20. Accountant or CPA or 
    Local Manager
    (person who can provide sales tax information if needed)

                         Address                                 City            State     Zip                                               Daytime Phone

21. Former Owner's Name:                                                                   Former Owner's License 
    (if applicable)                                                                                                                      No. 

22. Former Name of                                                                     Date of Purchase:                    /          /
    Business

23. Did the purchase price include fixed assets, machinery, or equipment? YES           NO Value $

24. State of Colorado Sales Tax License No.:                                                  Federal Employer I.D. (FEIN)

    I declare, under penalty of perjury in the second degree, that this application has been examined by me, that the statements made herein 
    are made in good faith pursuant to Colorado and the City of Evans tax laws and regulations, and to the best of my knowledge and belief, 
    are true, correct, and complete.

    Signed:                                                                                                                    Dated:
                          Name of Person Completing this Document

    Printed Name:                                                                                                              Title:

                      WHERE DO I GO TO GET INFORMATION ON LICENSING FOR THE STATE OF COLORADO?
    When opening a new business in the State of Colorado call the Colorado Business Assistance Center, (303) 592-5920 in Denver, or (800) 333-7798 toll-free in 
    Colorado for information.   Taxpayers are still required to remit State and County taxes directly to the State of Colorado.
    To obtain a sales tax, wage withholding tax, or other business tax account number, visit the Denver Service Center at 1375 Sherman St., Denver, or at the Fort Collins 
    Service Center 1121 W Prospect Rd, Bldg D, Fort Collins or any Taxpayer Service Center in Colorado. You may also get the "Colorado Business Registration" Form 
    (CR 0100) through the Colorado Department of Revenue web site at www.taxcolorado.com, or call the Forms Hotline at (303) 238-FAST (3278).

    Please be sure to check with other departments of the City to ensure compliance with all other applicable laws and regulations.  Issuance 
                    of the Business and Sales Tax License does not mean conformance with Zoning provisions, and/or other requirements.

    Pursuant to Section 3.04.500 (l) of the City of Evans Tax Code "failure to obtain a renewal license by the December 31st expiration date 
                                                            shall result in payment of an increased renewal fee…".  
                                                                 Thank You.

                                                            **PLEASE COMPLETE FRONT AND BACK OF APPLICATION**

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