Online Business Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Business Information Data consent *Yes, I give permission to store and process my dataIs your business home based? *YesNo(If “yes” you will also need to fill out a home occupation permit portion of this form.)Please check one of the following : *New BusinessChange of OwnershipExisting Business, change of AddressActual Business Startup Date *(at this location)Number of Full Time Employees(at this location)Form of BusinessCorporationLLCPartnershipSole ProprietorOtherBusiness NameDBA Name(if applicable)Description of BusinessTelephone *Fax *Email * License Address Address 1 *City, State *Zip Code * Mailing Address Address 1 *City, State *Zip Code * Business Owner Business Owner Name *Driver's License Number *Date of Birth *Home Address *City, State *Zip Code *Home Phone * 1 home Name Property Owner NamePhone NumberFax Optional GenderRace/Ethnic Group: (select one or more)WhiteBlack or African AmericanHispanic or LatinoAsianOther Previous Business Location AddressCity, StateZip CodeCheck any of the following that applyThis business sells tobacco.This business sells alcohol. (Please provide copies of State permits.)This business maintains inventory.Do you store or stock flammable or explosive materials?YesNoNote type and quantities:PLEASE NOTE: 1. IF YOU ARE NO LONGER IN BUSINESS, WRITTEN NOTIFICATION MUST BE SUBMITTED TO OUR OFFICE. 2. IF YOUR BUSINESS LOCATION CHANGES, AN APPLICATION FOR CHANGE OF ADDRESS MUST BE APPROVED. 3. CITATIONS WILL BE ISSUED TO BUSINESSES FAILING TO COMPLY WITH THE BUSINESS LICENSE ORDINANCE. 4. A FALSE STATEMENT OR MISREPRESENTATION MAY MAKE THE LICENSE NULL AND CONSTITUTE FORFEITURE OF ANY FEES PAID. 5. IF YOUR BUSINESS SELLS PREPARED FOOD YOU WILL BE REQUIRED TO PAY THE ADVERTISING AND PROMOTION 2% TAX. IF YOU’RE IN THE LODGING BUSINESS, YOU WILL BE REQUIRED TO PAY THE ADVERTISING AND PROMTION 4% TAX. CALL 501-370-3205 TO INQUIRE. You will not be able to apply for your business license unless you agree that the above information is true. If you do not agree, please contact the Treasury Management Division at (501) 371-4568. *I agree Signature of Owner or Representative: Name *FirstLastOwner or Representative Phone NumberDateSubmit
