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Revenue Department
275 N Union Avenue
PO Box 1987
Ozark, Alabama  36361
PHONE: (334) 774-5262
FAX: (334) 445-1054

BUSINESS LICENSE APPLICATION
(CONFIDENTIAL)

 

APPLICATION TYPE:
TYPE OF LICENSE:
BUSINESS ORGANIZATION:
LEGAL BUISNESS NAME/DBA:*
PHYSICAL ADDRESS*
MAILING ADDRESS:*
TELEPHONE:*
EMAIL ADDRESS:
BUSINESS ACTIVITIES: (Example- Contractor/Sub or General, Retail/Clothing Sales, Whoesale Foods, Equip. Rental, Computer Consulting, etc)*
ALATAX ACCOUNT #
ALATAX TAXPAYER NAME:
STATE CERTIFICATE #: (Required for Automobile Dealer, Beautification, Electrician, General Contractor, Heating/ AC Installer, Landscape, Homebuilder/Remodeler, Pawn Shop, and Pest Control)
SALES TAX #:
COMPETENCY CARD #: (Required for Plumbers and Plumbing Contractors)
HEALTH DEPT PERMIT #: (Required for food services)
FED TAX ID# OR SOCIAL SECURITY NUMBER:*
CONTACT PERSON NAME:*
CONTACT PERSON PHONE:*
CONTACT PERSON EMAIL:
LIST NAMES OF OWNER(S), PARTNER, OR OFFICERS
NAME/TITLE:*
RESIDENCE ADDRESS*
SSN/DLN*
NAME/TITLE:
RESIDENCE ADDRESS
SSN/DLN
NAME/TITLE
RESIDENCE ADDRESS
SSN/DLN
DATE BUSINESS ACTIVITY INITIATED OR PROPOSED IN OZARK,AL:
# OF EMPLOYEES IN OZARK,AL:

This application has been examined by me and is, to the best of my knowledge, a true and complete representation of the above named entity, and persons listed.

DATE:*
PERSON SUBMITTING:*
TITLE:

SHOULD THERE BE ANY QUESTIONS CONCERNING THE COMPLETION OF THIS FORM OR THE LICENSING AND/OR REGISTRATION PROCESS, PLEASE CALL 334-774-5262 TO OBTAIN A MORE DETAILED EXPLANATION.

Submit
*Required