(Sample) Business License Registration
May 12, 2018
submission
#16
Business Information
General Information
| Business Start Date | 2018-03-01 |
| Business Status | Renewal |
| Ownership Type | Sole Proprietorship |
Business Information
| DBA: | CALIFORNIA BIOMAGNETIC THERAPY |
| Name of Business | CALIFORNIA BIOMAGNETIC THERAPY |
| Business Address | 498 DOGWOOD CT TULARE CA 93274 |
| Mailing Address | 498 DOGWOOD CT TULARE CA 93274 |
| Phone | +15597236484 |
| Type of Business / Profession (Describe in detail) | ALTERNATIVE MEDICINE |
| No of Employees | --- |
| No of Units, if Residential / Commercial Rental | --- |
| Federal Tax Id No or Social Security No | --- |
| State Employer Id No | --- |
| Do you own or rent the property? | --- |
PROPERTY OWNER INFORMATION
| Property Owner Name | --- |
| Property Owner's Phone No | --- |
| Address | --- |
OWNERS, PARTNERS, OR CORPORATE OFFICERS INFORMATION
| Owner Name | MIGUEL MERCADO |
| Title | OWNER |
| Owner Address | --- |
| Social Security Number | --- |
| Driver's License | --- |
| Date of Birth | --- |
| Phone | --- |
| Emergency Phone | --- |
Acknowledgement
Acknowledgements
| Name (Printed) | --- |
| Title | --- |
| Date | --- |
| Upload signature | --- |