(Sample) Business License Registration
Oct 24, 2018
submission
#20
Business Information
General Information
| Business Start Date | 2018-10-01 |
| Business Status | New business |
| Ownership Type | Sole Proprietorship |
Business Information
| DBA: | Huffman Group LLc |
| Name of Business | NLMC |
| Business Address | 3624 Saguaro Cir |
| Mailing Address | 3624 Saguaro Cir |
| Phone | +17192333513 |
| Type of Business / Profession (Describe in detail) | consulting |
| 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 | --- |
| Is mailing address same as business address? | Yes |
OWNERS, PARTNERS, OR CORPORATE OFFICERS INFORMATION
| Owner Name | mark huffman |
| Title | owne |
| Owner Address | --- |
| Social Security Number | --- |
| Driver's License | --- |
| Date of Birth | --- |
| Phone | --- |
| Emergency Phone | --- |
Acknowledgement
Acknowledgements
| Name (Printed) | --- |
| Title | --- |
| Date | --- |
| Upload signature | --- |