Jenefer S. Hughes, MBA, ACA
Commissioner of the Revenue
CHESTERFIELD COUNTY, VIRGINIA
Application for Business License
Office of the Commissioner of the Revenue
P. O. Box 124
Chesterfield, VA 23832-0908
Tel: (804) 748-1281 Fax: (804)796-3236
cor@chesterfield.gov www.chesterfield.gov/comrev
2013
** IMPORTANT **
Renewal application must be
filed and tax paid in full by
3/1/2013. 2013 licenses will
expire on 12/31/2013.
FEIN or SSN #
Shaded area is FOR OFFICE USE ONLY.
Name
Date Filed
Date Processed
Trade Name
Mailing Address
START DATE
in Chesterfield County:
Local Address
(No PO Boxes
or mail drops)
FISCAL YEAR, if applicable,
(beginning & end dates):
____________ through ____________
OUT OF BUSINESS date
in Chesterfield County:
Telephone #
Local Ph. #
TYPE
OF
ENTITY
SOLE PROPRIETOR
PARTNERSHIP
E-mail address*
CORPORATION
LLC
ABC number: ______________________ Important: Any alcohol sales MUST be included in total gross receipts reported for retail merchants. See back.
CONTRACTORS: Important: Contractors MUST attach a list of subcontractors AND a list of deductions taken for work in other
State Board # ______________________ localities. See back for more details.
LICENSE CLASSIFICATIONS
#
DESCRIPTION
#
DESCRIPTION
01
03
02
04
LICENSE TAX CALCULATION
LICENSE 01
LICENSE 02
LICENSE 03
LICENSE 04
TOTALS
1.
2012 GROSS RECEIPTS**
(Or estimate for 2013 if business began after 1/1/2012)
2.
Exclusion. Enter $200,000 per license ONLY if Line 1 $200,000.
3.
ADJUSTED GROSS RECEIPTS** (Line 1 Line 2)
4.
TAX RATE (If applicable. See reverse.)
5.
2013 TAX (Line 3 x Line 4) or FEE (See reverse.)
IF START DATE IN CHESTERFIELD COUNTY WAS AFTER 1/1/11, COMPLETE LINES 6 12; OTHERWISE, SKIP TO LINE 13.
6.
2012 ESTIMATED gross receipts**
7.
2012 ACTUAL gross receipts**
8.
Exclusion. Enter $200,000 per license ONLY if Line 7 $200,000.
9.
2012 ADJUSTED ACTUAL gross rec.** (Line 7- Line 8)
10.
2012 TAX (Line 9 x 2011 tax rate) or FEE
11.
Less: 2012 tax PAID
12.
Net difference for 2012 (Line 10 Line 11)
13.
TOTAL TAX or FEE (Line 5 + Line 12)
14.
LATE PENALTY (1% per day, max. of 10%, $ 2 minimum.)
15.
INTEREST (10% per yr., 1/12 monthly the first of each month.)
16.
TOTAL DUE (Add Lines 13 through 15.)
* By providing your e-mail address, you are agreeing to receive Chesterfield County e-mail correspondence. Your address will not be shared with third parties.
** For WHOLESALE MERCHANT licenses, enter gross PURCHASES rather than gross receipts.
DECLARATION BY TAXPAYER I declare that the foregoing statements and figures are true, full, and correct to the best of my knowledge and belief. I
understand that even though the County may issue the license(s) herein applied for, it is the applicant’s responsibility to confirm with the County’s Planning
Department that the location listed above is properly zoned for the licensable activities being conducted there.
PLEASE PRINT NAME
SIGNATURE
DATE
BL00
click to sign
signature
click to edit
LICENSE FEE SCHEDULE
FOR BUSINESS LICENSE CLASSIFICATIONS WITH GROSS RECEIPTS* LESS THAN $200,000
Gross Receipts* Range License Fee
$0.00 $9,999.99 -0-
$10,000.00 $199,999.99 $10.00
Note: This fee schedule applies separately to each license classification.
LICENSE TAX SCHEDULE
FOR BUSINESS LICENSE CLASSIFICATIONS WITH GROSS RECEIPTS* OF $200,000 OR MORE
Rate
License Classification Basis Factor Minimum Tax
Professional Service Gross Receipts .0020 $10.00
Financial Service Gross Receipts .0020 $10.00
Note: Maximum tax for the Financial Service classification is $90,000.00.
Real Estate Service Gross Receipts .0020 $10.00
Utility Service Gross Receipts .0050 $10.00
Personal or Business Service Gross Receipts .0020 $10.00
Computer Service Gross Receipts .0003 $10.00
Commission Merchant Gross Receipts .0020 $10.00
Merchandise Broker Gross Profit .0020 $10.00
Amusement Machine Operator (coin-operated) Gross Receipts .0020 $10.00
Repair Service Gross Receipts .0020 $10.00
Retail Merchant Gross Receipts .0019 $10.00
Gasoline/Diesel retailers: Total of all retail gross receipts: $_____________ LESS excise taxes collected: $___________ = $_____________
(including non-gas receipts) (Line 1 on front)
Direct Seller Retail Gross Receipts .0019 $10.00
Merchant Placing Vending Machines Gross Receipts .0019 $10.00
Amusement/Admissions Gross Receipts .0019 $10.00
Contractor Gross Receipts .0014 $10.00
Note: Contractors must attach a list of any deductions claimed for work done in other localities where licenses were obtained, AND a
separate list of all subcontractors used for jobs in Chesterfield County during 2012, including contact information, job locations, and
total amounts paid to each. (Chesterfield County § 6-25c) Speculative builders must attach a list of completed projects.
Wholesale Merchant Gross Purchases .0010 $10.00
Note: Maximum tax for the Wholesale Merchant classification is $20,000.00.
Direct Seller Wholesale Gross Receipts .0005 $10.00
Note: Direct Seller categories apply only to consumer products sold in private residences.
FLAT FEES
FOR BUSINESS LICENSE CLASSIFICATIONS WITH FEES NOT RELATED TO GROSS RECEIPTS OR PURCHASES
License Classification Flat Fee Amount
Alcoholic Beverage Beer & Wine Sales $20.00
Alcoholic Beverage Mixed Beverage Sales
Seating Capacity: 1 100 $200.00
101 150 $350.00
over 150 $500.00
Flea Market/Craft Show/Trade Show Promoter $2.00**
**Per vendor per day, minimum of five vendors required
License Classification Flat Fee Amount
Itinerant Merchant Edible Perishables $50.00
Itinerant Merchant Goods, Wares, Merchandise $250.00
(January June)
Itinerant Merchant Goods, Wares, Merchandise $250.00
(July December)
Night Club Operator $100.00
Peddler Edible Perishables $25.00
Peddler Goods, Wares, Merchandise $500.00
(Max. $250.00)
IMPORTANT for ABC sales: Alcohol (ABC) sales MUST be included within total retail sales (gross receipts), including restaurant retail.
Total Alcohol sales ________________ + total other sales ____________________ = total retail gross receipts ____________________.
ADDITIONAL INSTRUCTIONS
If your business does not fit one of the above classifications or if you have any questions concerning your license classification, please call
(804) 748-1281.
If your federal income tax return is prepared on a fiscal year basis (other than calendar year), your base year MUST be the fiscal year
ending during the calendar year preceding the license year. Gross receipts* must be reported using the same method of accounting
as is used for federal income tax purposes.
Renewal applications and payments must be received or postmarked on or before 3/1/2013 to avoid late charges. Applications and
payments for new businesses must be received or postmarked within 30 days of beginning business in order to avoid late charges. Make
checks payable to: TREASURER, Chesterfield County.
* For WHOLESALE MERCHANT licenses, enter gross PURCHASES rather than gross receipts.