**PLEASE COMPLETE FRONT AND BACK OF APPLICATION**
CITY OF EVANS, COLORADO
BUSINESS AND SALES TAX LICENSE APPLICATION
BUSINESS AND SALES TAX LICENSE FEE: $25.00 Annual Renewal Due NOT LATER THAN December 31st
Mail to: For City Use Only
Monthly Sales Tax License
Quarterly General Registration
Annual NAICS Code
GEO Code
Amount Paid:
Check No.
Property Zoning:
Zoning Approval:
PLEASE COMPLETE APPLICATION IN FULL
(Illegible and/or incomplete forms may be rejected)
1. Type of Ownership: Sole Proprietor Partnership Limited Liability Corp. Other
2. Taxpayer Name (Owner, Partners or Corporate Name):
3. Trade Name ("Doing Business As"):
4. Business Address:
Street City State Zip
5. Mailing Address:
Street/ Post Office Box (If Different than Business Address) City State Zip
6. Business Phone No: First Day of Business in Evans: / /
7. Web Site Address:
E-mail Address:
(required)
8. Nature of Business (Check all that apply): Wholesale Construction Service Retail
Office Only Mail Order Communications/Telecom Finance/Insurance/Real Estate
9. What is your main product/service?
10. Do you sell, distribute, deliver, or grow Medical Marijuana? Yes No
11.
Is this business in a:
Commercial Building Private Residence
(if private residence, fill out Home Occupation Certificate form)
12. If a private residence, do your customer come to your home? Yes No
13. If located in Evans, what are your hours of operation?
14. If located in Evans, approximate sq. ft. of business:
15. If located in Evans, no. of employees (include self): Full Time Part-time
16. Yes No
If "YES", a separate application must be completed per business location.
17. Contact Person:
Address City State Zip Phone
Email (required)
AFTER EXPIRATION DATE, RENEWAL FEES INCREASE TO $50.00
PLEASE TYPE OR COMPLETE IN BLACK INK.
Corporation
SECTION ONE - All information provided in this section of the application is considered public information and is required to be released upon
public request.
Important: Please keep a copy of this application for your records.
City of Evans
BUSINESS AND SALES TAX OFFICE
1100 37th Street
EVANS, CO 80620
(970) 475-1109
(970) 330-3472 Fax
salestax@evanscolorado.gov
www.evanscolorado.gov
Do you have other locations in Evans?
Manufacturing
**PLEASE COMPLETE FRONT AND BACK OF APPLICATION**
SECTION TWO - All information provided in this section of the application is considered confidential.
18. Filing Frequency: $300 tax/month or more, file monthly
Under $300 tax/month, file quarterly
$300 tax/year or less, file annually
19. List Owner(s) or Corporate Officers: (attach supplemental sheet if necessary)
Position Home Phone
Home Address City State Zip code
Name Position Home Phone
Home Address City State Zip code
20.
Accountant or CPA or
Local Manager
(person who can provide sales tax information if needed)
Address City State Zip Daytime Phone
21.
Former Owner's Name:
(if applicable)
22.
Former Name of
Business
/ /
23. Did the purchase price include fixed assets, machinery, or equipment? YES NO Value $
24. State of Colorado Sales Tax License No.: Federal Employer I.D. (FEIN)
Signed: Dated:
Name of Person Completing this Document
Printed Name: Title:
WHERE DO I GO TO GET INFORMATION ON LICENSING FOR THE STATE OF COLORADO?
Thank You.
Please be sure to check with other departments of the City to ensure compliance with all other applicable laws and regulations. Issuance
of the Business and Sales Tax License does not mean conformance with Zoning provisions, and/or other requirements.
Business and Sales Tax License Application (con't)
Name
Pursuant to Section 3.04.500 (l) of the City of Evans Tax Code "failure to obtain a renewal license by the December 31st expiration date
shall result in payment of an increased renewal fee…".
When opening a new business in the State of Colorado call the Colorado Business Assistance Center, (303) 592-5920 in Denver, or (800) 333-7798 toll-free in
Colorado for information. Taxpayers are still required to remit State and County taxes directly to the State of Colorado.
To obtain a sales tax, wage withholding tax, or other business tax account number, visit the Denver Service Center at 1375 Sherman St., Denver, or at the Fort Collins
Service Center 1121 W Prospect Rd, Bldg D, Fort Collins or any Taxpayer Service Center in Colorado. You may also get the "Colorado Business Registration" Form
(CR 0100) through the Colorado Department of Revenue web site at www.taxcolorado.com, or call the Forms Hotline at (303) 238-FAST (3278).
I declare, under penalty of perjury in the second degree, that this application has been examined by me, that the statements made herein
are made in good faith pursuant to Colorado and the City of Evans tax laws and regulations, and to the best of my knowledge and belief,
are true, correct, and complete.
Date of Purchase:
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signature
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