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 |
Teddy cleaning services llc
|
| Business Street Address (Physical location of the business cannot be a PO Box) |
---
|
| Mailing Address (Street name and number only) |
---
|
| Mailing Address City, State, & Zip Code |
---
|
| Business Phone Number |
+19283500082
|
| Alternate # (Emergency Phone Number) |
---
|
| Number of Employees |
---
|
| Please read through the list carefully and select the closest description of your business: |
JANITORIAL CLEANING
|
| Business Description (Please describe in detail the nature of the business) |
---
|
| Start of business date |
2024-09-10
|
| 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 |
---
|
Transaction Privilege Tax (Sales Tax)
| Transaction Privilege Tax (TPT) Number |
---
|
Professional Licenses
| Professional License or Permit Number & Description |
---
|
Applicant Information (Must be completed by the person filling out this application)
| Name (First and Last) |
Jesus M Lopez Garcia
|
| 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) |
---
|
| Email Address |
[email protected]
|
Application Affidavit
