P.O. Box 98 • 230 N. Tubb Street • Oakland, FL 34760 • 407.656.1117 x 11 (voice) • 407-656-2940 (fax)
APPLICATION FOR LOCAL BUSINESS TAX
PLEASE COMPLETE THIS FORM AND ATTACH ALL APPROPRIATE REQUIREMENTS. APPLICANT MAY
HAND WRITE OR TYPE THIS APPLICATION.
CHECK ONE:
___________ New Business to Oakland
___________ Address Change – Former Address _________________________________________________
___________ Business Name Change – Former Name _____________________________________________
BUSINESS NAME:___________________________________________________________________________
PHYSICAL LOCATION OF BUSINESS:_________________________________________________________
MAILING ADDRESS OF BUSINESS:___________________________________________________________
BUSINESS PHONE ______________________________ BUSINESS FAX: ___________________________
BUSINESS OWNER(S) NAME OR CORPORATION NAME: ________________________________________
E-MAIL ADDRESS: __________________________________ WEB SITE: ____________________________
SOCIAL SECURITY OR FEDERAL ID #:__________________ DRIVER’S LICENSE #:
HOME ADDRESS:___________________________________________________________________________
HOME PHONE: ____________________________ MOBILE PHONE: ______________________________
BUSINESS MANAGER’S NAME: (IF APPLICABLE) _____________________________________________
BUSINESS MANAGER’S ADDRESS: ___________________________________________________________
BUSINESS MANAGER’S PHONE: _____________________ MOBILE PHONE: ______________________
BUILDING OWNER’S NAME: (IF RENTING):___________________________________________________
BUILDING OWNER’S ADDRESS:______________________________________________________________
BUILDING OWNER’S PHONE: _______________________ MOBILE PHONE: ______________________
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PERSON TO NOTIFY IN CASE OF EMERGENCY – SHOULD HAVE KEY TO OFFICE
NAME: __________________________________ NAME: __________________________________________
ADDRESS:________________________________ ADDRESS: _______________________________________
PHONE: _________________________________ PHONE: _________________________________________
MOBILE PHONE: _________________________ MOBILE PHONE: _______________________________
ADDRESS WHERE LICENSE AND/OR CORRESPONDENCE SHOULD BE MAILED:
___________________________________________________________________________________________
TYPE OF BUSINESS OR OCCUPATION: _______________________________________________________
Occupational License Form
24/07/2010
Page 1 of 3
# of Employees: ___________ COPIES OF ALL APPLICABLE BUSINESS LICENSES: _____YES _____NO
FOR COMMERCIAL BUSINESSES PLEASE PROVIDE THE APPLICABLE INFORMATION
A. Beauty/Barber/Nail/Tan Salons: # of Units _________________________________________
B. Merchants, Wholesale/Retail: Estimated value of Inventory $_______________________________________
C. Mini-Warehouses: Total Square Footage _________________________________________________Sq.Ft.
D. Mobile Home Parks/Motels/Apartments: # of Units ______________________________________________
E. Restaurants: # of Seats _____________________________________________________________________
F. Vending Machines (Candy/Soda/Cig./Etc.) # of Units ____________________________________________
G. Signage: # of Signs up to 15 Square Feet in size _________________________________________________
# of Signs over 15 Square Feet in size __________________________________________________
(SEPARATE BUILDING PERMIT REQUIRED BEFORE CHANGING/ADDING ANY TYPE OF SIGNAGE
FOR YOUR BUSINESS)
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TYPE OF ALARM SYSTEM: Silent Intrusion: ____________________ Silent Robbery __________________
(IF APPLICABLE) Audible Intrusion: __________________ Other:__________________________
Alarm Company Name: _______________________________________________________________________
Phone #: ________________ Does alarm reset? ______ No _____ Yes
If yes, how long aer sounding?: __________
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I CERTIFY THAT THE INFORMATION GIVEN ABOVE IS TRUE AND TO THE BEST OF MY KNOWLEDGE.
I UNDERSTAND THAT ANY FALSE INFORMATION GIVEN IN THIS APPLICATION MAY BE SUFFICIENT
CAUSE TO HAVE THIS LICENSE REVOKED. ISSUANCE OF THIS LICENSE DOES NOT AFFECT THE
STATE OF FLORIDA OR COUNTY OF ORANGE REQUIREMENTS FOR SEPARATE OR SPECIAL LICENSES.
I ALSO CERTIFY THAT I HAVE RECEIVED AND UNDERSTAND THE RULES AND REGULATIONS FOR A
HOME OCCUPATIONAL LICENSE. Initial __________
IT IS FURTHER UNDERSTOOD THAT THIS LICENSE IS FOR THE PRIVILEGE OF ENGAGING IN THE
BUSINESS, PROFESSION, OR OCCUPATION SHOWN AND ONLY AT THE LOCATION SHOWN HEREON
AND THAT I WILL COMPLY WITH THE CODE OF THE TOWN OF OAKLAND. FAILURE TO CORRECT
CONDITIONS ON THE PREMISES THAT ARE IN VIOLATION OF THE TOWN CODE OR TO NOTIFY THE
TOWN CLERK OF ANY CHANGE WILL RESULT IN REVOCATION OF SAID LICENSE. Initial __________
SIGNATURE OF APPLICANT: _____________________________________ DATE: __________________
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OFFICE USE ONLY:
ZONING AND USE APPROVAL BY PLANNER __________ approved __________ denied
LOCAL BUSINESS TAX CLASSIFICATION NUMBER(S): _______________________________________
SPECIAL REQUIREMENTS:______________________________________________________________
______________________________________________________________________________________
Occupational License Form
24/07/2010
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COMMENTS:___________________________________________________________________________
______________________________________________________________________________________
APPROVED BY:_________________________________ DATE: _____________ FEE: $___________
Occupational License Form
24/07/2010
Page 3 of 3