additional help for that field. (If you do not see
CITY OF NEWPORT NEWS, VIRGINIA
OFFICE OF THE COMMISSIONER OF THE REVENUE
BUSINESS CLASSIFICATION INFORMATION (BCI)
Please complete a separate form for each business location in Newport News
Attach additional pages if space is not sufficient
Moving your mouse over a field will display any
Use the Tab key (not the Enter key)
to move to the next field.
1. BUSINESS/OWNER NAME:
2. TRADE NAME:
3. BUSINESS ADDRESS:
For assistance call 757-926-8651
APT
the help, download the current version of
Acrobat Reader.)
APT
ZIP
5.%86,1(66(0$,/$''5(66BUSINESS WEBSITE ADDRESS:
ZIP
6. BUSINESS PHONE NUMBER: EXTENSION:
8. FEDERAL I.D. NUMBER: 9. OWNER'S SOCIAL SECURITY NUMBER:
10. DATE BUSINESS BEGAN IN NEWPORT NEWS (mm/dd/yyyy):
11. ESTIMATED ANNUAL GROSS RECEIPTS (Provide gross purchases if wholesaler):
$
12. DESCRIPTION OF BUSINESS (Provide complete description of work performed/services provided):
A. CURRENT ACTIVITY
B. PROPOSED FUTURE ACTIVITY
13.
DO YOU OR YOUR COMPANY HOLD A STATE LICENSE OR STATE CERTIFICATION?
(IF
YES,
PLEASE
LIST
TYPES
AND
PROVIDE
A
COPY.)
14. PLEASE CHECK ALL THAT APPLY TO YOUR BUSINESS:
SELL CIGARETTES
SELL PREPARED FOOD
CHARGE ADMISSION FEE/ COVER CHARGE
CHARGE FOR BOARDING AND LODGING
RENT EQUIPMENT OR PROPERTY
15. DESCRIBE THE NATURE OF THE BUSINESS' COMPENSATION (E.g., payment for products sold, services rendered, commissions, etc.):
16. TYPES OF CUSTOMERS/CLIENTS (E.g., private individuals, other businesses, walk-in customers, etc.):
17. JOB LOCATION (If you are a contractor and your business is located outside of Newport News):
18. LIST ANY OTHER BUSINESSES AT THIS LOCATION:
For lines 19 and 20, do NOT include vehicles or real property. For assistance in answering questions 19 and 20, call 757-926-8644.
19.
TOTAL ORIGINAL COST OF EQUIPMENT, FURNITURE AND FIXTURES, ETC.:
$
20. TOTAL ORIGINAL COST OF MACHINERY AND TOOLS:
$
Please notify this office immediately in the event of any changes in this information
TIFFANY M. BOYLE, COMMISSIONER OF THE REVENUE, CITY HALL, 2400 WASHINGTON AVENUE, NEWPORT NEWS, VA 23607
7. OWNERSHIP TYPE (Check one)
LIMITED LIABILITY COMPANY
SOLE PROPRIETORSHIP
CORPORATION
PARTNERSHIP (Attach list with name and SSN of each partner)
OTHER (Specify):
SIGNATURE OF AUTHORIZED AGENT: DATE:
Don't forget to sign the form!
TITLE:
This information is true and correct to the best of my knowledge and belief.
NAME OF AUTHORIZED AGENT (Print):
4. MAILING ADDRESS (Same as Business Address?):
