City of Dayton, Kentucky

New Business License Form for Year:

I. BUSINESS INFORMATION

Name of Business:

Business Address:

Employer ID #:

(EIN or SSN)

Business Telephone #:

Date Taxable Year Ended:

Email Address:

Type of Business:

No data to display

Corporation

Partnership

LLC

Sole Proprietorship

Principal Business Activity:

# of Employees

Contact Person:

(Name and Telephone)

Owners/ Partners/ Corporate President Name, Address, Phone #, DOB, and SSN:

Intended start date of business:

Fee due first year of business: $60 | Fee if no business license is not obtained before start of business: $120.

III. ACKNOWLEDGEMENT & SIGNATURE

RETURN MUST BE SIGNED – I hereby certify, under penalty of perjury, that the statements made herein and in any supporting schedules are true, correct, complete and
to the best of my knowledge.

New Business License Form for Year:

Name of Business:

Business Address:

Employer ID #:

Business Telephone #:

Date Taxable Year Ended:

Email Address:

Type of Business:

No data to display

Principal Business Activity:

# of Employees

Contact Person:

Owners/ Partners/ Corporate President Name, Address, Phone #, DOB, and SSN:

Intended start date of business:

Signature of PREPARER:

Print Name:

Signature of LICENSEE:

Print Name:

New Business License Form for Year:

Name of Business: *

Business Address: *

Employer ID #: *

Business Telephone #: *

Date Taxable Year Ended:

Email Address: *

Type of Business: Clear More No data to display

Principal Business Activity:

# of Employees *

Contact Person:

Owners/ Partners/ Corporate President Name, Address, Phone #, DOB, and SSN: *

Intended start date of business: *

Signature of PREPARER: *

Print Name: *

Signature of LICENSEE: *

Print Name: *

Name of Business:

Business Address:

Employer ID #:

Business Telephone #:

Email Address:

Type of Business:

No data to display

# of Employees

Owners/ Partners/ Corporate President Name, Address, Phone #, DOB, and SSN:

Intended start date of business:

Signature of PREPARER:

Print Name:

Signature of LICENSEE:

Print Name: