City of Fairfield, Alabama Business Application The citly does impose the business license tax inj its police jurisdiction.  Complete and Return This Form To:  CONFIDENTIAL)  Applicant Complete This Box Federal Employer Identification Number (FEIN). State of Alabama Tax# # FORM OF OWNERSHIP (Check One) Sole! Prop. Corporation LLC. LLP_  MAIL:  The City of Fairfield Revenue Department P.O. Drawer 437 Fairfield, AL: 35064 205-783-6005  FAX:  Partnership. Prof Assoc. Other  E-MAIL: censelommglarteda.us  Please type or print clearly and complete fully to avoid processing delays. See reverse fori instructions and further information. Application Type: New D Owner Change D Name Change D Location Change D Update D  Legal Business Name:, Trade Name: (Ifo different from above). Physical Address: Mailing Address: Telephone:  Street Street ( Local Business  City City Corporate Office  State State Fax  Zip Zip  Company' Website /Facebook Page. Contact E-Mail Address  Contact Name Contact Phone (.  Business Activitles: (Brief description- Retail clothing sales, wholesale food sales, rental of industrial equip.. computer consulting, etc)  List business owner(s), partner(s), andlor officer(s). Attach separate sheet if necessary.  Name  Title  Social Security Number Residence Address  Date Business Activity Initiated or Proposed in Fairfield: the above named entity and person(s) listed.  Number of Employees in Fairfield  lam authorized to complete this form and, tot thel best of my! knowledge, all the information provided is a true and complete representation of  Date  Signature  Print Name    Ifyour business will have a physical location within the municipality please use that address on the front of this form, provide a copy of your lease or proof of building ownership, and submit al hand-drawn or mechanical Upon receipt of the completed form, the municipality will provide any additional forms and information regarding  schematic of the building use(s).  other specific requirements to you in order to complete the licensing process.  All license renewals are due January 1 and delinquent after January 31 (or February 15), with these exceptions:  Alcoholic Beverage License: Due January 1, delinquent after January 15 Insurance Company License: Due January 1, delinquent after March 1  This form is intended as a simplified, standard mechanism for businesses to initiate contact with a municipality concerning their activities within that city. A business license will be required prior to engaging in business. If a business intends to maintain a physical location within the city, there are normally zoning and building code Inc certain instances, a business may simply be required to register with the city to create a mechanism for the reporting and payment of any tax liabilities. If that is the case, you will be provided the materials for that registration The completion and submission of this form does not guarantee the approval or subsequent issuance of a license to do business. Any prerequisites for a particular type and location oft the business must be satisfied prior to licensing.  approvals required prior toi the issuance of al license.  process.  Please call 205-788-2492 if you have questions about this form or the licensing and/or registration process.  For Fairfield City Office Use Only  Reviewed By:.  Review Date:  License #. Zoning Classification:  Physical Location: a inside City Limits 0 Outside City Limits  Building Approval: 0 Yes D No D N/A  NAICS: Lip. Code 4:  SIC: Lic. Code 5_ Alcohol  Lic. Code 1: TaxTypes:  Lic. Code 2:.  Lic. Code 3:  Sales/Seller's Use D Consumer Use  Rental  Lodgings DOther_  C Occupational  Tobacco Quarterly  Gas/Motor Fuel D Business License  Tax Filing Frequency: D Monthly Business Type: D Retail  Annual  Wholesale J Building Contractor Service  - Professional  Manufacturer D Rental  Regulated  DOther  COFRD Bus App Rev.2-5.02.2017