Town Business License

TOWN OF WATERVILLE

P. O. Box 580

Waterville, WA 98858

509-745-8871 / Fax: 509-745-8782

Required per Ordinance 97-574 and 02-623

2014 BUSINESS LICENSE APPLICATION / RENEWAL FORM

Business License No. – 2014-

Business:

IRS Tax ID #:

(Required)

FEES MUST ACCOMPANY APPLICATION & CANNOT BE USED AS A CREDIT FOR BUSINESS TAX

Issued to (owner): .

Business or trade name:

Name of Applicant (if not owner):

Signature of Applicant: ______

PLEASE MARK ANY CORRECTIONS OR ADDITIONS BELOW

Location Address:

Mailing Address:

Type of business (in detail):

Phone: Fax: Cell:

Type of business: { (M) Manufacturing, (R) Retail, (W) Wholesale, (S) Service, (C) Contractor }

Business ownership: { (I) Individual (P) Partnership ( C) Corporation }

Names of other persons having interest in the business, either proprietors or owners:

FOR TOWN USE ONLY

Renewal/Application Date: Renewal/Application Fee: $ 5.00

Receipt No. Late Fee: $ (if renewed after 3/31/14)

Renewal taken by: Town Clerk __ / Deputy ___

License Status: ____ Approved ____ Disapproved