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Kodiak Alaska Business License - PDF

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					                                 Application for Certificate of Registration
                                           (Transient Bed Tax and Severance Tax)



TO:      Kodiak Island Borough
         710 Mill Bay Road
         Kodiak, AK 99615
A. Applicant Information

Name of Firm      _______________________________________________________                      Acct No._________________
Physical Address _______________________________________________________
Mailing Address _______________________________________________________                        Business Phone
Name of Owner _______________________________________________________                          (_____)_________________
Owner’s Home Address__________________________________________________                         Home Phone
Type of Business _______________________________________________________                       (_____)_________________
Date Business Started____________________________________________________
Alaska Business License No.______________________________________________



B. Organization Information


Type of Organization               Individual        Partnership       Corporation            Other (explain below)

Is Business Seasonal?              Yes               No
If yes, list approximate dates     From:             To:               No. of months:
business operates each year.


C. Certification Statement

I certify that the information on this application is true and correct. Any misstatements or omissions will result in civil
action as directed by the borough assembly.
Print or Type Name of Applicant________________________________________________
Signature & Title of Applicant__________________________________________________


D. To Be Completed If A Partnership or Corporation
Name             _____________________ Title                            __________________         Phone      ____________
Mailing Address _____________________ Home Address                      __________________
                 _____________________

Name                 _____________________          Title               __________________         Phone      ____________
Mailing Address      _____________________          Home Address        __________________
                     _____________________

Name                 _____________________          Title               __________________         Phone      ____________
Mailing Address      _____________________          Home Address        __________________
                     _____________________
                                 Application for Certificate of Registration
                                           (Transient Bed Tax and Severance Tax)



TO:      Kodiak Island Borough
         710 Mill Bay Road
         Kodiak, AK 99615
A. Applicant Information

Name of Firm      _______________________________________________________                      Acct No._________________
Physical Address _______________________________________________________
Mailing Address _______________________________________________________                        Business Phone
Name of Owner _______________________________________________________                          (_____)_________________
Owner’s Home Address__________________________________________________                         Home Phone
Type of Business _______________________________________________________                       (_____)_________________
Date Business Started____________________________________________________
Alaska Business License No.______________________________________________



B. Organization Information


Type of Organization               Individual        Partnership       Corporation            Other (explain below)

Is Business Seasonal?              Yes               No
If yes, list approximate dates     From:             To:               No. of months:
business operates each year.


C. Certification Statement

I certify that the information on this application is true and correct. Any misstatements or omissions will result in civil
action as directed by the borough assembly.
Print or Type Name of Applicant________________________________________________
Signature & Title of Applicant__________________________________________________


D. To Be Completed If A Partnership or Corporation
Name             _____________________ Title                            __________________         Phone      ____________
Mailing Address _____________________ Home Address                      __________________
                 _____________________

Name                 _____________________          Title               __________________         Phone      ____________
Mailing Address      _____________________          Home Address        __________________
                     _____________________

Name                 _____________________          Title               __________________         Phone      ____________
Mailing Address      _____________________          Home Address        __________________
                     _____________________

				
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Description: Kodiak Alaska Business License document sample