If yes, under what company name is payroll paid? ________________________________________________________
Do you have 1099 employees working in Murray? Yes _____ No_____ (If so please attach a copy of 1099’s)
Estimated number of 1099 Employees _____ If you are a general contractor will you be using subcontractors? Yes__ No__
If you answered yes, you must provide a list of subcontractors to the City of Murray.
Murray location(s) and phone number if different from above_________________________________________________
Do you lease the property where the business is located? Yes_____ No_____
If yes, provide owner’s name and phone number ___________________________________________________________
Payroll Tax Withholding Requirement:
The City
of Murray imposes an occupational tax of 1% of all gross earnings earned by an employee who receives a W2 for
work performed and services rendered in the city limits of Murray. This applies to every resident and non-resident who works in
Murray. It is the responsibility of each employer to withhold this tax and pay on the required periodic basis. Employers who
fail to withhold or pay the tax to the City shall be personally liable to the City for any sums due, unless exempt to be withheld.
Address___________________________________________________________________________________________
Phone Number____________________________
_________________________________________________________
**PLEASE NOTE** It is the applicant’s responsibility to inform the City of Murray of any changes in
ownership, addresses, number of employees or termination of business activity. The undersigned (business)
agrees to be responsible for all collection costs and attorney’s fees in connection with any delinquent
account.
I declare under penalty of perjury that the above application is true and correct to the best of my knowledge. I certify that I will
operate my business in accordance with all applicable federal, state, and city laws and regulations and permit enforcement
authority onto business property of such laws and regulations.
Signature: __________________________________________ Title: ________________________ Date: _________________
OFFICIAL USE ONLY
Zoning Location: ________ CUP Required: _____Yes _____No____Signage: _____Yes _____No Fire Inspection Fee: $_____________
Approved By: ______________________________________ Date: _________________ Fire Inspection Invoice #:____________________
Classification:_________________________________________________ Fee Amount:$___________ Business License #: _______________
Comments:_________________________________________________________________________________________________________
Please provide contact information below for person completing this application:
Page 2 of 2
FORM
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Name____________________________________________________________________________________________
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