Fillable BUSINESS TAX APPLICATION (City of Fremont)

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BUSINESS TAX APPLICATION (City of Fremont)

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File type: PDF

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Finance Department - Revenue Division
Ph: (510) 494-4790 | Fax (510) 494-4754 39550
Liberty Street, P. O. Box 5006
Fremont, CA 94537-5006
www.fremont.gov
Business Tax No.
New Business
Home Occupation Form Required
Out-Of-Town Business
Change of Owner
Change of Business Name
Location Change
2nd Location
BUSINESS TAX APPLICATION
Signature of Owner or Authorized Agent
Business Name
Ownership
State License No.
Sellers Permit No.
Email Address
License Type
Federal Tax ID No.
Expiration Date
State Tax ID No.
Phone No.
Alternate/Cell
Bus. Start Date in Fremont
In case of emergency, please contact
(attach additional sheet, if necessary)
Date
Corporation Name
(if
different)
Business Location
Corporation
LLC
Partnership
Sole Proprietor
Trust
1st Owner Name
(Cannot be P.O. Box per State of California Business & Professions Code-Section 17538.5)
Home Address
2nd Owner Name
Title
Driver Lic. No.
Soc. Sec. No.
Phone No.
Contact Name
Address
Home Address
Title
Driver Lic. No.
Soc. Sec. No.
Phone No.
(Cannot be P.O. Box)
(Cannot be P.O. Box)
Website Address
Phone No.
Cell No.
Please complete ALL SPACES related to your business. Please type or print clearly in ink.
CHECK ALL APPROPRIATE BOX(ES) AND DESCRIBE BUSINESS ACTIVITY. WRITE PERCENTAGE IF MORE THAN ONE.
Provide detailed description of business activity conducted in Fremont.
Does your company sell products over the internet? YES/NO Or by catalog? YES/NO
NOTE: Payment of Business Tax does not relieve the Applicant (Business) of the requirement to
comply with Zoning, Health, Safety and other regulations (State, City and Federal). All persons
conducting a business in/from the City of Fremont are required to
pay the City Business Tax and any related
fees. It is important that the City has a correct and accurate record of your business. The application for a
FREMONT BASED BUSINESS is subject to a review process. I hereby certify under penalty of making a
false oath that the information contained herein is, to the best of my knowledge and belief, a true
and complete statement.
I understand that it is my responsibility to renew or close my business tax account prior to its
expiration date.
Phone Number
NOTICE: Under federal and state law, compliance with
disability access laws is a serious and significant
responsibility that applies to all California building owners and
tenants with buildings open to the public. You may obtain
information about your legal obligations and how to comply
with disability access laws at the following agencies: The
Division of the State Architect at
www.dgs.ca.gov/dsa/Home.aspx
-
The Department of
Rehabilitation at
www.rehab.cahwnet.gov -
The California
Commission on Disabil
ity Access at www.ccda.ca.gov.
LLP
______%
Applicant's Printed Name
Check No.
Seq. No.
Amt Paid
Date Paid
OFFICIAL USE ONLY
Fax No.
______%
Retail Sales
Wholesale
Warehousing
Manufacturing
Real Estate
Service
Professional Services
Administrative Office (No Sales)
Rental Property
Property Management
______%
______%
______%
______%
______%
______%
______%
______%
Number of employees at Fremont Location including owner:
What is the square footage at your location:
Does your business share occupancy with another business? If yes, list name of
business:
If your business has more than one location in Fremont, indicate the location(s):
Please check here if you do not wish to have your business
information listed on 3rd party business lists.
Enter below names of Owners, Partners, or Corporate Officers - DO NOT LEAVE BLANK (attach additional sheet, if necessary)
Printed 8/30/2018: 2:19 pm
RD_BTA/ec – Revised 09/2018
Click to print:
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BUSINESS TAX APPLICATION, p.2
Finance Department - Revenue Division
(510) 494-4790
39550 Liberty Street, P. O. Box 5006
Fremont, CA 94537-5006
www.fremont.gov
Fax (510) 494-4754
All persons conducting a business in/from the City of Fremont are required to pay the City Business Tax and any related fees. It is very important that the City has
a correct and accurate record of your business.
The a
pplication for FREMONT BUSINESS TAX is subject to a review process.*
* In order to open a business, approval may be required from the Planning Division, Building & Safety Division, Police Department, Fire Department, and/or the
Alameda County Health Depa
rtment.
Business Name:
Business Location:
(Cannot be P.O. Box)
Number Street City State Zip
OFFICIAL USE ONLY
Returned to Revenue by:
Taxpayer #:
Occ. Grp.:
Bldg. Insp. File #:
MIS #:
SIC:
Construction Type:
Department Reviewer Comments
Department Other Comments
Zoning District
Appl Rec'd
Reviewed (See Comments)
Name of Reviewer
Date
Zoning
Building Inspection
Fire/Hazardous Mat Dept.
Police Dept.
Health Dept.
494-4455
494-4460
494-4285
790-6972
567-6700
Printed 8/30/2018: 2:19 pm
RD_BTA/ec – Revised 09/2018
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BUSINESS TAX APPLICATION (City of Fremont)

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Completed 3 August 2020

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