Business License Application
Business Status
| What would you like to do today: |
---
|
New Application
| Is this a: |
None of the above
|
Business Name and Physical Location
| Business Name or Trade Name |
Parker's Paws
|
| Business Street Address (Physical location of the business cannot be a PO Box) |
---
|
| Mailing Address (Street name and number only) |
---
|
| Business Phone Number |
+19512171888
|
| Alternate # (Emergency Phone Number) |
---
|
| Number of Employees |
---
|
| Please read trough the list carefully and select the closest description of your business: |
SERVICE BUSINESS
|
| Business Description (Please describe in detail the nature of the business) |
---
|
| Start of business date |
2024-12-31
|
| Locations where the business or applicant has operated during the last five (5) years |
---
|
| is the business location: |
---
|
| Nature of Ownership |
---
|
Individual/ Sole Proprietor Owner Information (Eligibility Form)
| Name (First and Last) |
---
|
| Title |
---
|
| Home street address (cannot be a PO Box) |
---
|
| Social Security Number (Last four (4) digits only) |
---
|
| Phone Number |
---
|
| *Check the box next to the document you are presenting to the Town, indicating lawful presence |
---
|
| Attach a copy of said document |
---
|
Federal Tax ID or Social Security Number
| Please provide your Federal ID or Social Security Number |
---
|
Applicant Information (Must be completed by the person filling out this application)
| Name (First and Last) |
Pamela Buchanan
|
| Home Address (No PO Boxes) |
---
|
| Mailing Address |
---
|
| Phone number |
---
|
| Driver's License Number |
---
|
| Driver's License Expiration Date |
---
|
| Date of Birth |
---
|
| Social Security Number (Last four (4) digits only) |
---
|
Application Affidavit
