Fillable Business License Application Information/Instructions (City of Republic, Missouri)

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Business License Application Information/Instructions (City of Republic, Missouri)

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COMMUNITY DEVELOPMENT DEPARTMENT
204 North Main
Republic, Missouri 65738-1472
Phone: (417) 732-3150 Fax: (417) 732-3199
licensing@republicmo.com
Revised 04/30/2020
Business License Application
Information/Instructions
Thank you for choosing to do business in the City of Republic. Below is a checklist of
items that may be required as part of your application.
IMPORTANT NOTE – According to city ordinances, it is unlawful to operate a
business before receiving your Business License. Applicants should allow two weeks
for processing. A Business License number is assigned when the application is turned
in; however, the number is only a tracking device and is not valid until you have
received your Business License certificate.
□ Complete the attached Business License application form and return to the Community
Development Department with your payment.
□ If you will be operating the business out of your home, please complete the Home Based
Business Questionnaire and submit with your Business License application form.
□ If you will be operating any type of construction business, you must provide a copy of
your current Workers’ Compensation Liability certificate. If you are the sole employee,
then you may complete the Missouri Exemption Form. The form is available in our
office and must be notarized.
□ If you collect any sales tax, you must provide your Missouri Tax Identification Number
and a copy of your current (within 90 days of the application date) Missouri “No Tax
Due” statement. Contact the Missouri Department of Revenue at
www.dor.mo.gov/business
for more information.
□ If you will be providing any food services, you will need to contact the Greene County
Health Department at (417) 864-1017 as soon as possible to determine if a permit will be
required. You may need to provide them a copy of your building plans as well.
□ If you are a new commercial business with a physical location inside the Republic city
limits, if you will be remodeling your business location, if you will be putting up a sign
for your business, etc., you will need to contact our office to determine if additional
permitting will be required.
If you have any questions regarding the items listed above, please contact the
Community Development Department at (417) 732-3150.
COMMUNITY DEVELOPMENT DEPARTMENT
204 North Main
Republic, Missouri 65738-1472
Phone: (417) 732-3150 Fax: (417) 732-3199
licensing@republicmo.com
Revised 04/30/2020
Business License Fees
Regular Business License
*
Prorated fee beginning October 1st *
$50.00
$25.00
Banks and Manufacturing
*
$75.00
Home-Based Business * – other restrictions may apply
(Businesses located inside Republic city limits only)
$25.00
Itinerant Merchant (includes Mobile Food Vendors) *
Fee based upon size/weight of vehicle
Capacity of ½ ton or less
Capacity of ½ ton not exceeding 1 ½ ton
Capacity of over 1 ½ ton
$20.00 or
fraction
$30.00 or
fraction
$50.00 or
fraction
Apartment Houses, Hotels and Motels *
($50 for first unit, $1 for each additional unit)
$50.00 +
Solicitor License – other restrictions apply
License for a period longer than 90 days *
Temporary Solicitor License (90 day license)
$75.00
$35.00
Temporary Seasonal License - for a period not to
exceed 90 days. This license cannot be renewed.
$25.00
Relocation (Change of Address Form)
$10.00
* Expires December 31
st
of each year
COMMUNITY DEVELOPMENT DEPARTMENT
204 North Main
Republic, Missouri 65738-1472
Phone: (417) 732-3150 Fax: (417) 732-3199
www.republicmo.gov
Republic Business License Application
Please answer all questions completely.
Incomplete and unsigned applications will delay processing.
All business licenses expire on December 31
st
and must be renewed prior to that date.
Date: ____________________________
A
Reason for Applying
New Business License Reinstating Old Business
Purchase of Existing Business Other:
B
Business Name and Physical Location
1. Business Name (DBA Name)
2. Physical Location – Street (Do not use PO Box or Rural Route Number)
State
Zip Code
3. Business Telephone Number
If applicable, list the name of your business Facebook page
Facebook.com/ _________________________________________________
4. Describe the business activity, stating the major products sold and service provided.
Retail ____________________________ Service ____________________________
Wholesale ________________________ Manufacturer ______________________
Other ____________________________
Contractor _________________________
C
Business Activity
5. Do you offer retail sales of the following items? Select all that apply.
Alcoholic Beverages Alternative Nicotine Cigarettes or Other Tobacco
Precious Stones Gold/Silver E-Cigarettes or Vapor Products
✔
Business License Application
Page 2 of 5
D
Ownership Type
6. Ownership Type:
Sole Proprietor Partnership Government Trust
All ownership types listed below, unless specifically exempted, are required to be
registered with the Missouri Secretary of State’s Office.
A copy of your registration is
to be included with this application. For more information regarding registering your
business, visit the Secretary of State’s website at www.sos.mo.gov.
Limited Partnership Limited Liability Partnership Limited Liability Company
Missouri Corporation Non-Missouri Corporation
E
Owner Information
7. Owner Name (Enter Corporation, LLC or Partnership Name, if applicable).
Address
E-mail Address
City
State
Zip Code
County
If an individual is listed as the owner, you must also provide the following:
Date of birth (MM/DD/YY)
Telephone Number
F
Mailing Address (Forms, Licenses and Notices will be mailed to this address)
8. Address (street, rural route or PO Box)
City
State
Zip Code
G
Officer, Partner or Member
9. Provide the officer, partner or member of your business who will be responsible for
the purchase of the Business License.
Name (Last, First, Middle Initial)
Title
Home Address
City
State
Zip Code
County
Date of Birth
(MM/DD/YY)
Business License Application
Page 3 of 5
H
Retail Sales (Sales Tax Requirement)
10. If you are required to collect and/or pay sales tax within the City of Republic, you
are required to have a Sales Tax ID Number issued by the State of Missouri. Is your
business required to collect sales tax within the City of Republic? If yes, please attach a
copy of your Missouri No Tax Due Statement (issued from the Missouri Department of
Revenue). For more information, visit www.dor.mo.gov.
Yes
No My business sales tax ID# is:________________________________
I
Contractors and Subcontractors
11. Per RSMo. 287.061 - If you are a Contractor or Subcontractor, you are required to
provide a copy of your Workers’ Compensation Insurance Certificate. If you are exempt
by the Missouri State guidelines, you will be required to fill out the Missouri Exemption
Form WC-134 (Please ask our office for a copy).
If you are a Subcontractor, please list the Contractor you will be working for:
J
Home Based Businesses (Located inside the city limits of Republic)
12. If your business is operated in your home and is located inside the city limits of
Republic, please fill out the “Home Based Business Questionnaire
” (Please ask our
office for a copy).
K
Zoning Requirements
13. If you have a physical location inside the city limits and are applying for a
commercial business license, please contact the Community Development Department
at 417-732-3150 for a Change of Occupancy Permit.
14. City Ordinance #05-72 requires your business provide designated handicapped
parking spaces at your place of business and you must show compliance when
applying for a business license (Please attach a picture of your handicapped parking
spaces and sign).
15. Do you plan to make any changes to the building or property associated with the
business?
Yes
No
If you plan to make changes, you will need to contact the Community Development
Department prior to approval of your business license.
16. If you will be building a fence or adding an accessory building to the premise, please
contact the Community Development Department for the necessary permits.
Business License Application
Page 4 of 5
For review and signature.
Under penalties of perjury, I declare
the above information and any attached
supplements are true, complete and correct. I understand that filing false information
may result in the closing of my business. This application must be signed by the owner,
if the business is a sole proprietorship, or by an individual listed in the Officer, Partners,
or Members section of this application. The signing party is acknowledging they have
direct supervision or control over the business license.
State and/or Federal law provisions regulate the presence of aliens in the United States.
I understand that pursuant to 2008 Missouri House Bill 1549 certain public benefits are
prohibited by law from being provided to aliens unlawfully present in the United States
and that I do not and will not knowingly employ a person who is an unauthorized alien
in connection with the business for which the permit or license has been or is being
obtained and assert
the obtaining of the permit or license will not violate the prohibition
on providing certain public benefits for aliens unlawfully present in the United States as
set forth in H.B. 1549. Should I become aware, after issuance of the permit or license
and during the term of the permit or license that the business is in violation of H.B.
1549, I will immediately notify the City of the violation. I understand failure to do so
may result in denial/revocation/suspension of the permit or license. After notification
of the violation is provided to the City, the business shall immediately advise the City
of steps being taken to correct the violation. F
ailure to timely correct the violation may
result in denial/revocation/suspension of the permit or license.
L
Employees
17. Total number of employees you anticipate will be working for your business?
Full Time (Including yourself) _________________________
Part-Time (Including yourself) ________________________
M
Food and/or Beverages
18. If you will be selling food and/or beverages, an inspection may be required from the
Greene County Health Department prior to approval of your business license. For more
information, contact the Health Department at (417) 864-1017.
Does your business sell food and/or beverages?
Yes
No
Have you contacted the Greene County Health Department?
Yes
No
Business License Application
Page 5 of 5
I understand that I am not to conduct business until my application has been approved
and my business license has been received.
Signature of Applicant
Title
Date
(MM/DD/YY)
Printed Name
E-Mail Address
Mail to: Community Development Department
204 North Main Street
Republic, MO 65738
Phone: (417) 732-3150
Fax: (417) 732-3199
E-mail: licensing@republicmo.com
FOR OFFICE USE ONLY
Business License Fee Collected $__________________________ Date Paid: ______________________________
Fee collected by: _______________________________________
Business License
Assigned Number: ______________________
Form revised 04-27-2020
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Business License Application InformationInstructions (City of Republic, Missouri)

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Completed 19 January 2021

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