Business Registration

Business Information

Business Name	Donald C. Stinespring & Associates
Business Street Address (Including Unit or Suite, if applicable)	---
Mailing Address (If different than business street address above)	PO Box 382, Richmond IL 60071-0382
Business Phone	+18156784553
Email Address	---
Would you like to sign up for the Village E-Blast for current events and information?	---
Website Address	---

Business Owner Information

Business Owner(s) Name	---
Business Owner(s) Home Address	---
Business Owner(s) Phone Number (Home or Cellphone)	---

Is This A New Business?

Is This A New Business?

No, my business was registered under the same name prior to May 1st of this year.

Other Important Information

Illinois Sales and Use Tax and/or Retailers Occupation Tax	---
Operating Days	Monday, Tuesday, Wednesday, Thursday, Friday
Operating Hours	9-5
Number of Shifts	1
Number of Employees	5
Nature of Business	Donald C. Stinespring & Associates

Fueling Stations

Does your business have fueling stations on site?

No

Hoses

Number of gas hoses

0

Police Required Information

Burglar Alarm	Yes
Fire Alarm	Yes
Hazardous Materials	No

Burglar Alarm

Please Provide Additional Information	---
Monitoring Agency	---
Monitoring Agency Telephone Number	---
Alarm Type	---

Fire Alarm Information

Please Describe Alarm Box Location	---
Monitoring Agency	---
Monitoring Agency Telephone Number	---
Alarm Type	---

Emergency Contacts: Please provide 3 names/phone numbers of key holders who are available 24 hours in case of an emergency.

1) Name	Donald Stinespring jr
1) Phone Number	+18152458957
2) Name	William Gebis
2) Phone Number	+18153470210
3) Name	Sue Coon
3) Phone Number	+18155756746

Late Fees

Was this submitted after May 22?

No

Prorated Fees

Was this submitted between August 1 - October 31?	No
Was this submitted between November 1 - January 31?	No
Was this submitted After February 1?	No

Certification Number

Certificate No

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