City of Longview
Application for ADMISSIONS LICENSE
Administrative Services Department
P.O. Box 128 Longview, WA. 98632 (360) 577-3308
LICENSE TYPE
LICENSE FEE
ADMISSIONS
NAME OF APPLICANT HOME PHONE ZIP
$10.00
MAILING ADDRESS
CITY
STATE
BUSINESS NAME
BUSINESS PHONE
BUSINESS ADDRESS
CITY
STATE
ZIP
DESCRIPTION OF BUSINESS
PLEASE CHECK ONE BOX:
IF SPECIAL EVENTS BOX CHECKED, PLEASE COMPLETE THE FOLLOWING: DATE OF SPECIAL EVENT DESCRIPTION OF SPECIAL EVENT
ADMISSIONS CHARGED ON A REGULAR BASIS (Theaters, Cabarets with cover charges, etc.) ADMISSIONS CHARGED FOR A SPECIAL EVENT (One-time event. If another special event is held at a later time, this license will be valid for that event; however, the City Finance Department must be notified and must approve the event.)
REFERENCES (If required by Finance Dept.)
DATE
TITLE
SIGNATURE
Admission taxes of 5% of gross revenue generated by admissions charge will be due and payable within 15 days of each special event. Businesses which regularly charge for admission will be billed on a quarterly basis. References may be required for special events, the determination to be made by the City Director of Administrative Services.
FOR OFFICE USE ONLY
Date Paid Receipt No. Amount Paid Comments
License Mailed