Platteville Colorado Real Estate by ctn13806


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									                                                  TOWN OF PLATTEVILLE, COLORADO
                                                     Business / Sales Tax/ Contractors License Application

                                                                                                         Business License Fee               $50.00
                                                                                                        Sales Tax License Fee               $15.00
                                                                                                       Contractors License Fee              $50.00
                                    If license is not approved, all fees will be returned minus $15.00 for administrative cost.

                                 Mail To:                                                                   For Town Use Only
                                                                                  Monthly                 Business License
                          Town of Platteville                                    Quarterly               Sales Tax License
                         Town Clerk's Office                                       Annual               Contractors License
                           400 Grand Avenue                                      Seasonal                    Special Permit
                     Platteville, Colorado 80651
                            (970) 785-2245
                            (303) 776-1117                                      Amount Paid                      Date Rec’d
                          (970) 785-2476 Fax                                      Check No.                       Rec’d By
                                                                                 Receipt No.

        PLEASE TYPE OR COMPLETE IN BLACK INK                                                  PLEASE COMPLETE APPLICATION IN FULL
                                                                                             (Illegible and/or incomplete forms may be rejected)

     SECTION ONE – All information provided in this section of the application is considered public information and is required to be
     released upon public request.

1      Type of Ownership:                   Sole Proprietor        Partnership           Corporation           Limited Liability Corp.         Other _______

2      Taxpayer Name (Owner, Partners or Corporate Name):                 ____________________________________________________________________

3      Trade Name (“Doing Business As or DBA”):                           ____________________________________________________________________

4      Physical Business Address:        ___________________________________________________________________________________________
                                                   Street Address                   City                   State             Zip

5      Mailing Address:                 ____________________________________________________________________________________________
                                        Street/PO Box (If Different than Business Address) City            State            Zip

6      Phone Number(s):                 ______________________/_______________________
                                         Business Phone          Corporate Phone

7      Web Site Address:                 ___________________________________                 E-Mail Address:     _____________________________________

8      Nature of Business (Check all that apply):             Wholesale         Manufacturing           Construction              Service            Retail

                                             Office Only             Oilfield            Communications/Telecom               Finance/Insurance/Real Estate

9      What is your main product/service?           ____________________________________________________________________________________

10      Is this business in a:         Private Residence                   Commercial Building

11      Do you lease or own your building?     Lease           Own               Approximate sq. ft. of business space: ______________
              Property Owner/Manager Name          Street Address, City, State, Zip Code                            Area Code and Phone No.

12      Number of Employees (include self):        Full Time _________                    Part-time     __________
         #of Employees that live in Platteville (if Oilfield service)

13      Do you have other business locations in Platteville?          Yes           No             Date business opened:      _____________________

          If “YES”, a separate application must be completed per business location.

14      Owner, Local Manager or Registered Agent (Corporate Officer):

       Name                              Address                       City          State          Zip          Phone

                                                                  (Continued on Reverse Side)
          SECTION TWO – All information provided in this section of the application is considered confidential.

15   List Owner(s) or Corporate Officers: (attach supplemental sheet if necessary)

     Name                                                  Position                                 Home Phone

     Home Address                                          City                              State           Zip

     Name                                                  Position                                Home Phone

     Home Address                                          City                              State           Zip

16   Local Manager or        ___________________________________________________________________________________________________
     Representative:         (Contact Person) Name                    Address               City            State         Zip

17   State of Colorado Sales Tax License No.:          _________________________            Federal Employer I.D. (FEIN)        ______________________

18   State Assigned NAISC Code (if known):             _________________________

          SECTION THREE – For Contractor’s License Only

19   Insurance company certificate – need copy and be put on as a certificate holder**
            **Insurance Company Name:_______________________________________________________________
                    **General Liability - $250,000 Min Each Occurrence
                    **General Liability - $500,00 Min Aggregate
                    **Workers Comp (If have employees)
                    **Auto - $250,000 Min Single Limits
                    **Auto - $500,000 Min Aggregate

20   *Has the applicant ever been denied or had a license revoked to conduct any business?
      If yes, attach a notation as to the circumstances:                                                 Yes           No

I declare, under penalty of perjury in the second degree, that this application has been examined by me, that the statements made herein are made in
good faith pursuant to Colorado and the Town of Platteville tax laws and regulations and to the best of my knowledge and belief, are true, correct, and

Signed:             ______________________________________________________________________                          Title:   ______________________
                    Must be person that is legally responsible for business (i.e., owner, partner, officer, etc.)

Printed Name:       ______________________________________________________________________                          Title:   ______________________

          Please be sure to check with other departments of the Town to ensure compliance with all other applicable laws and regulations.
          Issuance of the Sales Tax License does not mean conformance with Zoning provisions, and/or other requirements.

                                                                FOR YOU INFORMATION


          When opening a new business in the State of Colorado call the Colorado Business Assistance Center, (303)592-5920 in Denver.

          To obtain a sales tax, wage withholding tax, or other business tax account number, visit the Denver Service Center at 1375 Sherman
          Street, Denver, or any Taxpayer Service Center in Colorado. You may also get the “Colorado Business Registration” Form (CR 0100)
          through the Colorado Department of Revenue web site at, or call the Forms Hotline at (303)238-FAST (3278).

                                                 There are no door to door sales in the Town of Platteville.

                                                                        THANK YOU

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