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WA STATE UBI#
BUSINESS OR TRADE NAME (DBA)
PHYSICAL ADDRESS OF BUSINESS
BUSINESS PHONE
MAILING ADDRESS OF BUSINESS Check if same as physical address
BUSINESS LICENSE CONTACT NAME
PHONE
EMAIL ADDRESS
TAX CONTACT NAME
PHONE EMAIL ADDRESS
(OTHER THAN ABOVE OR OWNER)
BUSINESS ENTITY TYPE COMMERCIAL BUSINESS DES MOINES BASED BUSINESS
Individual/Sole Proprietorship Corporation Partnership LLC Non-
Profit 501 Government Entity
First Activity Date in Des Moines
Projected Des Moines Revenue
Number of Employees working in the
City of Des Moines
Nature of Business (Check All That Apply)
Retail Manufacturing-Extracting
Service Utility
Wholesale Sales Office
Printing/Publishing Door to Door Sales (Solicitor)
Mobile Food Vendor MWBE Certified
Other
Detailed Description of Principal Business Activity in Des Moines
In City Business Outside City Business (Businesses located in another city, but entering Des Moines to engage in business)
Adult Famliy Home Family Daycare Property Rental - # of Units_______
New Business Additional Location Location Change New Ownership Name Change
Des Moines Municipal Code 5.04.020 requires all persons wishing to conduct any business within the City of Des Moines to first secure a City of Des
Moines business license. I understand that I am responsible for notifying the Finance Department of any change in the status of my business as well
as any new mailing addresses. I declare under the penalty of perjury that the information provided on this application, is true and accurate. I
understand my place of business must comply with Federal, State and local codes and ordinances.
Des Moines Business License Application
21630 11
th
Ave S. Suite A, Des Moines, WA 98198
Phone: 206-870-7582
Email address: taxandlicensing@desmoineswa.gov
In City Annual License Fee: $75.00 - After July 1
st
: $37.50
Outside City Business Annual License Fee: $100.00 - After July 1
st
: $50.00
FILL OUT THIS FORM COMPLETELY (INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED)