Application Type
(select one)
Initial business license
registration fee $25
Regulated Licenses
Peddlers $25/year
or $10/day
Solicitors $100/year
or $10/ day
Carnival/Circus $300/ week
(must have Mayor’s permission)
Pawnbroker $250/year
Delivery $50/year
Billiard $200/year
+ $25/table
Fleamarkets $100/year
Vending $10/machine/year
(A list of all serial #’s of each
machine is required)
CITY OF BEREA
APPLICATION FOR OCCUPATIONAL LICENSE
212 CHESTNUT STREET BEREA, KY 40403 PHONE: 859-986-7218
Pursuant to City Ordinance, firms or organizations engaged in any trade or profession operating
in the City of Berea for profit or gain, to first register with the City.
Legal Business Name ___________________________________________________________
Doing Business As ______________________________________________________________
Mailing Address: _______________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Physical Address (if different than above): ___________________________________________
_______________________________________________________________
Contact Person: Name: ________________________________________________________
Title: __________________________________________________________
Mailing Address: ________________________________________________
City/State/Zip: __________________________________________________
Phone: ______________________________ Fax: _____________________
Email: _________________________________________________________
Check Entity Type:
[ ] Individual, [ ] Partnership, [ ] Corporation, [ ] Limited Liability Partnership
[ ] Limited Liability Company filing as:
___ Individual, ___ Partnership, ___ Corporation
[ ] Non-Profit, must attach IRS acknowledgement of tax exempt status
[ ] Other _________________________________________________________________
Please attach name, home address and phone of owner(s), partner(s), members, or if a corporation list officers and titles.
Accounting Period per Federal Tax Return:
[ ] Calendar Year [ ] Fiscal Year Ending: _____________________________________________________________ ________________
Social Security or Federal Tax ID Number: _______________________________________________________________________________
Nature or Description of Business: ______________________________________________________________________________________
_________________________________________________________________________________________________________________
Date Operations Started in Berea: ______________________________________________________________________________________
Do you have or will you have employees working in Berea: [ ] Yes [ ] No If yes, how many? ____________________________________
Do you have subcontractors or any other contract labor: [ ] Yes [ ] No If yes, please attach a detailed listing.
It is understood that the City of Berea has an occupational license fee on net profits from business conducted within the City. An annual return
must be filed whether or not the business has shown a profit. It is also understood that the license fee must be withheld from earnings of
employees working in the City and remitted to the City quarterly (or monthly if more than 50 employees).
I hereby certify that the information in this application is true and correct to the best of my knowledge and belief.
Authorized Signature: _________________________________ Title: _____________________________________ Date: ______________
OFFICIAL USE ONLY
Amount Received: ______________________________ Codes Approval: __________________________________
Payment Type: [ ]Cash [ ]Check (#____ ) [ ]Credit Card Date: ___________________________________________
Date received: _________________________________
Received by: ___________________________________ Inside City Limits: [ ] Yes [ ] No
Effective 5/1/2014
