TOWN OF PORT ROYAL, VIRGINIA APPLICATION FOR BUSINESS LICENSE  20-  for period beginning Applicant Street Address Post Office Trading as  20  and ending  20  State  Zip  Location where business to be conducted Date Applicant began business in Virginia Date Applicant began business at above location Other business locations outside the Town of Port Royal: Names and addresses of partners if applicant is a partnership:  Applicant is: : ()Individual ()Partnership ()Virginia Corporation ()Foreign Corporation  (Date of charter if  av Virginia corporation or date of qualification to do business in' Virginia if a foreign corporation)  Applicant applies for the following licenses (specify):  1). 2). 3).  code section  Basis of Tax (e.g. amount of gross receipts or number of units operated)  Tax $ $ $ Totals $  Penalty $ $ $ $  Fee $ $ $ $  1). 2). 3).  Total Taxes, Penalties, and Fees  OATH -1, the undersigned applicant, do swear (or affirm) that the above statements and figures are true, complete  and correct to the best of my knowledge and belief.  Signature of Applicant Authorized Agent  by  LICENSE and ending.  l,the Treasurer of the Town of Port Royal, Virginia, do find the above application to be in due form and accompanied by professions, or employments set forth in the application at the specified location in the Town of Port Royal for the period  the sum of$_ beginping.  Therefore licenses are this day granted the applicant named therein to transact the business,  20_  20_  Date  Town Treasurer    TOWN OF PORT ROYAL, VIRGINIA APPLICATION FOR BUSINESS LICENSE  20-  for period beginning Applicant Street Address Post Office. Trading as  20  and ending  20  State,  Zip  Location where business to be conducted Date Applicant began business in Virginia Date Applicant began business at above location Other business locations outside the Town of Port Royal: Names and addresses of partners if applicant is a partnership:  Applicant is: : ()Individual ()Partnership ()Virginia Corporation ()Foreign Corporation  (Date of charter if  av Virginia corporation or date of qualification to do business in' Virginia if ai foreign corporation)  Applicant applies for the following licenses (specify):  1). 2). 3).  code section  Basis of Tax (e.g. amount of gross receipts or number of units operated)  Tax $ $ $ Totals $  Penalty $ $ $ $  Fee $ $ $ $  1). 2). 3).  Total Taxes, Penalties, and Fees  OATH -1, the undersigned applicant, do swear (or affirm) that the above statements and figures are true, complete  and correct to the best of my knowledge and belief.  Signature of Applicant Authorized Agent  by  LICENSE and ending.  l,the Treasurer of the Town of Port Royal, Virginia, do find the above application to be in due form and accompanied by professions, or employments set forth in the application at the specified location in the Town of Port Royal for the period  the sum of $ beginping.  Therefore licenses are this day granted the applicant named therein to transact the business,  20_  20_  Date  Town Treasurer